December 12, 1980

Legionnaires' disease not limited to lungs

JAMA. 1980;244(23):2597-2601. doi:10.1001/jama.1980.03310230007004

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Much of the mystery has been stripped from Legionnaires' disease since its startling appearance in 1976, but the emerging clinical picture is no less ominous in several respects.

Recent reports indicate that systemic spread from the lungs is more common than previously thought, that there may be more than 71,000 deaths in adults from unrecognized Legionnaires' disease in the United States annually (JAMA 1980;243:2311-2313), and that diagnosis remains a challenge.

The latest findings on systemic dissemination indicate that Legionella pneumophila spreads from the lungs to other organs in about one of every four patients, especially if there is concurrent disease.

This conclusion comes from a retrospective study of 23 fatal cases of Legionnaires' disease conducted by Dennis D. Weisenburger, MD, Charles M. Helms, MD, PhD, and Edward D. Renner, PhD, and presented to the joint St Louis meeting of the College of American Pathologists and the American Society of Clinical