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Medline ® Abstract for Reference 65

of 'Epidemiology and pathogenesis of Legionella infection'

65
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Legionellosis and biologic therapies.
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Bodro M, CarratalàJ, Paterson DL
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Respir Med. 2014 Aug;108(8):1223-8. Epub 2014 Jun 18.
 
BACKGROUND: Biologic therapies are widely used in inflammatory diseases, and they are associated to an increased infection risk, especially to granulomatous and intracellular infections such as Legionella.
RESULTS: A review of the literature revealed 105 cases of Legionella pneumonia in patients taking biologic therapies. Sixty-four patients (65.3%) were treated with infliximab, 23 (23.5%) with adalimumab, 5 (5%) with etanercept and 3 (3%) with rituximab. Seventy-one per cent of the patients were treated for rheumatologic diseases and 16% for inflammatory bowel diseases. The majority of the patients received one or more concomitant immunosuppressive drugs, especially steroids (43%). Overall mortality was 19%. Legionella pneumonia might complicate therapy with biologic therapies, especially in patients being treated with infliximab or adalimumab given concomitantly with other immunosuppressive medications during their first 6 months of treatment.
CONCLUSION: Physicians should be aware of this potentially severe association. Early recognition and treatment would likely result in reduced morbidity and mortality.
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IDIBELL, Institute of Biomedical Research of Bellvitge Hospital, Infectious Diseases Department, Hospital Universitari de Bellvitge, University of Barcelona, Barcelona, Spain; University of Queensland Centre for Clinical Research, Brisbane, Australia. Electronic address: martabodro@gmail.com.
PMID