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September 15, 1978

Legionnaires' disease holds diagnostic pitfalls

JAMA. 1978;240(12):1227. doi:10.1001/jama.1978.03290120021006

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When Legionnaires' disease burst on the clinical scene in mid-1976, the question was: What kind of infection is this? Today, the question is more likely to be: Is this particular pneumonia Legionnnaires' disease?

Help in answering that question is coming from several sources.

At the American Society for Microbiology's recent conference on diagnostic immunology in Atlanta, for example, Gary L. Lattimer, MD, and Luther V. Rhodes III, MD, of Allentown, Pa, and R. A. Ormsbee, PhD, and M. G. Peacock, PhD, of the Rocky Mountain Laboratory (National Institute of Allergy and Infectious Diseases) underlined the problem by emphasizing that Legionnaires' disease and psittacosis can be confused.

"This consideration is significant," Dr Lattimer emphasized, "because of the mortality associated with inappropriate therapy for either of these two disease entities."

At the same time, the Pennsylvania and (Hamilton) Montana investigators suggested a diagnostic aid: IgM rather than IgG. Their conclusion is based