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Legionellosis and biologic therapies.
[legionellosis]
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
.
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
.
Physicians
should
be
aware
of
this
potentially
severe
association
.
Early
recognition
and
treatment
would
likely
result
in
reduced
morbidity
and
mortality
.
Diseases
Validation
Diseases presenting
"early recognition"
symptom
22q11.2 deletion syndrome
cadasil
child syndrome
cowden syndrome
cushing syndrome
cystinuria
familial mediterranean fever
homocystinuria without methylmalonic aciduria
kindler syndrome
legionellosis
oligodontia
omenn syndrome
pyomyositis
thoracic outlet syndrome
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