What is the prognosis and outcome for patients who have contracted Legionnaires’ disease?
If the patient is treated with
appropriate antibiotics near the onset of pneumonia, the outcome is
excellent, especially if the patient has no underlying illness that
compromises his/her immune system. For patients whose immune
systems are compromised, including transplant recipients, delay of
appropriate therapy can result in prolonged hospitalization,
complications, and death.
For those patients who are discharged
from the hospital, we have found that many will experience fatigue,
loss of energy, and difficulty concentrating for several months
after discharge from the hospital. In a long-term study of 122
survivors of Legionnaires’ disease in the Netherlands, symptoms of
fatigue (75%), neurologic symptoms (such as concentration problems
and malaise) (75%), and neuromuscular symptoms (such as joint pain
or muscle weakness) (79%) had persisted 17 months later (Lettinga
KD, Clin Infect Dis, July 1, 2002). Respiratory tract symptoms were
also present, but in lower frequency including cough (48%) and
shortness of breath on exertion (38%). It could not be determined
whether or not the persistence of these symptoms were due to
specifically for Legionnaires’ disease or for severe pneumonia, in
general.
Serious sequelae, fortunately, are
rare. In our experience, most patients will recover completely
within one year. If the patients are cigarette smokers, the
patients should discontinue smoking.