Legionella spp

Clinical

- Almost always requires valve surgery.


Diagnosis

  • Blood cultures - requires special blood culture media

  • Urine for Legionella antigen

  • Serology

  • Culture, immunohistology and PCR of surgical material

Optimal duration of therapy unknown; may be up to 5-14 months.


Therapy Dose Duration
Levofloxacin 750mg IV/PO daily ≥ 6 weeks
or    
[Erythromycin 500mg PO/IV q6h ≥ 6 weeks
+    
Rifampin] 300mg PO bid ≥ 6 weeks

Alternative

Therapy Dose Duration
Doxycycline 200mg PO bid ≥ 6 weeks