Legionnaires’ Disease (Legionella Pneumonia / 레지오넬라증) (Kor/Eng)

Legionnaires’ Disease (Legionella Pneumonia / 레지오넬라증)

 

 

 

 

Definition (정의)

English:
Legionnaires’ disease is a severe form of pneumonia (lung infection) caused by the bacterium Legionella pneumophila.
It commonly spreads through inhalation of aerosolized water droplets contaminated with the bacteria (e.g., from air conditioning systems, humidifiers, or hot water tanks).
It is not spread person-to-person.

Korean (한국어):
레지오넬라증(Legionnaires’ disease) 은 레지오넬라 폐렴균(Legionella pneumophila) 에 의해 발생하는 중증 폐렴입니다.
냉각탑, 샤워기, 온수기, 에어컨 등의 오염된 물방울(에어로졸) 을 흡입함으로써 감염됩니다.
사람 간 전염은 거의 없습니다.

 

 

 

 

 

 

 

 

Causative Agent & Transmission (원인균 및 전파경로)

ItemEnglishKorean

Causative agent	Legionella pneumophila (Gram-negative bacillus)	레지오넬라 폐렴균 (그람음성 간균)
Reservoir	Stagnant warm water (e.g., air-conditioning cooling towers, hot tubs, plumbing systems)	따뜻한 물이 고인 환경 (냉각탑, 욕조, 배관 등)
Transmission	Inhalation of contaminated aerosols	오염된 물방울 흡입
Not spread by	Person-to-person contact	사람 간 접촉으로 전파되지 않음

 

 

 

 

 

 

Pathophysiology (병태생리)

English:
After inhalation, Legionella bacteria enter the lungs and are engulfed by alveolar macrophages.
Instead of being destroyed, the bacteria replicate within macrophages, leading to inflammation, alveolar damage, and pneumonia.
Severe infection can cause multi-organ involvement, especially kidneys and CNS.

Korean (한국어):
흡입된 Legionella 균은 폐의 대식세포(macrophage) 내로 들어가 파괴되지 않고 그 안에서 증식합니다.
이로 인해 폐포 염증과 손상 → 폐렴이 발생하며, 심할 경우 신장이나 중추신경계까지 영향을 줄 수 있습니다.

 

 

 

 

 

 

 

Clinical Manifestations (임상 증상)

System / StageEnglish DescriptionKorean Explanation

Respiratory	Cough (usually dry), dyspnea, chest pain	기침(보통 마른기침), 호흡곤란, 흉통
Systemic	High fever (>39°C), chills, malaise	고열(39°C 이상), 오한, 권태감
GI symptoms	Diarrhea, nausea, vomiting, abdominal pain	설사, 구역, 구토, 복통
Neurologic	Confusion, headache, lethargy	혼돈, 두통, 무기력
Other	Hyponatremia (↓ sodium), relative bradycardia	저나트륨혈증, 상대적 서맥

Note:
Legionnaires’ disease often causes pneumonia + GI + CNS symptoms — this triad is a key diagnostic clue.

 

 

 

 

 

 

 

Complications (합병증)

• Respiratory failure (ARDS)
• Septic shock
• Acute renal failure
• Death, especially in elderly or immunocompromised patients

Korean:

• 호흡부전 (ARDS)
• 패혈성 쇼크
• 급성 신부전
• 사망 위험, 특히 고령자, 면역저하자에서 높음

 

 

 

 

 

 

Diagnosis (진단)

TestEnglish DescriptionKorean Explanation

Chest X-ray	Patchy or multilobar infiltrates	반점형 또는 다엽성 침윤
Urinary antigen test	Detects Legionella pneumophila serogroup 1 antigen	Legionella 항원을 소변에서 탐지
Sputum culture	Growth on Buffered Charcoal Yeast Extract (BCYE) agar	BCYE 배지에서 균 배양
PCR / Serology	Confirms bacterial DNA or antibodies	PCR 또는 항체 검사

 

 

 

 

 

 

 

 

Treatment (치료)

CategoryEnglishKorean

Antibiotics of choice	Macrolides (Azithromycin, Clarithromycin) or Fluoroquinolones (Levofloxacin, Moxifloxacin)	마크로라이드계 (Azithromycin, Clarithromycin) 또는 플루오로퀴놀론계 (Levofloxacin, Moxifloxacin)
Severe cases	IV antibiotics, oxygen therapy, fluid balance	정맥 항생제, 산소요법, 수액조절
Duration	Usually 10–21 days depending on severity	중증도에 따라 10~21일 치료
No person-to-person isolation required	Only environmental control	사람 간 격리는 필요 없고, 환경관리 중요

 

 

 

 

 

 

 

 

 

 

 

 

Nursing Considerations (간호중재)

English:

• Monitor respiratory status (O₂ saturation, RR, breath sounds).
• Administer prescribed antibiotics and monitor for side effects.
• Provide oxygen therapy as needed.
• Encourage adequate hydration to loosen secretions.
• Monitor for electrolyte imbalance (esp. hyponatremia).
• Educate about infection source control (e.g., clean humidifiers, air systems).

Korean (한국어):

• 호흡상태(산소포화도, 호흡수, 청진음) 모니터링.
• 항생제 투여 및 부작용 관찰.
• 필요시 산소요법 제공.
• 수분섭취를 충분히 하도록 격려하여 객담 배출 도움.
• 전해질 이상(저나트륨혈증) 관찰.
• 환경위생 교육: 에어컨, 샤워기, 가습기 등 정기적 청소 강조.

 

 

 

 

 

 

 

Prevention (예방)

• No vaccine available.
• Regular cleaning and disinfection of water systems, cooling towers, and humidifiers.
• Maintain hot water temperature above 60°C to kill bacteria.

Korean:

• 예방백신 없음.
• 냉각탑, 온수기, 배관, 가습기 등 정기적인 청소와 소독 필요.
• 온수를 60°C 이상 유지하면 균 사멸.

 

 

 

 

 

 

Summary Table (요약표)

CategoryEnglish SummaryKorean Summary

Causative agent	Legionella pneumophila	레지오넬라 폐렴균
Transmission	Inhalation of contaminated aerosols	오염된 물방울 흡입
Key Symptoms	Pneumonia + GI + CNS symptoms	폐렴 + 위장관 + 신경계 증상
Lab finding	Hyponatremia	저나트륨혈증
Treatment	Macrolides / Fluoroquinolones	마크로라이드 / 플루오로퀴놀론
Prevention	Environmental sanitation	환경위생 관리
Contagion	Not person-to-person	사람 간 전염 없음

 

 

 

 

Quick Nursing Tip:

 Think of “Atypical Pneumonia with GI symptoms and hyponatremia” = Legionnaires’ disease
 Environmental control (clean air-conditioning, water systems) is key to prevention.
 Use Azithromycin or Levofloxacin for treatment.