Letters to the Editor| Volume 42, ISSUE 11, P1248-1250, November 2014

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Editorial commentary: Risk assessment and prediction for health care–associated Legionnaires' disease: Percent distal site positivity as a cut-point

      Legionella has been reported as the single most commonly reported pathogen associated with disease outbreaks from drinking water.
      • Craun G.F.
      • Brunkard J.M.
      • Yoder J.S.
      • Roberts V.A.
      • Carpenter J.
      • Wade T.
      • et al.
      Causes of outbreaks associated with drinking water in the United States from 1971 to 2006.
      Two strategies have been proposed for risk assessment. The first is the strategy advocated by the Centers for Disease Control and Prevention (CDC) to search assiduously for Legionnaires' disease in all cases of hospital-acquired pneumonia. However, the diagnosis is commonly missed, even if the Infectious Diseases Society of America and American Thoracic Society guidelines are followed.
      • Hollenback B.
      • Dupont I.
      • Mermel L.A.
      How often is a work-up for Legionella pursued in patients with pneumonia? A retrospective study.
      Given that the clinical manifestations of Legionnaires' disease are nonspecific, laboratory tests are required for diagnosis. The most accurate test is culture on selective media, which is not widely available.
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