Detection and quantification of Legionella pneumophila DNA in serum: case reports and review of the literature

1 Laboratory of Medical Microbiology and Immunology, St Elisabeth Hospital, PO Box 747, 5000 AS Tilburg, The Netherlands 2 Laboratory of Microbiology and Infection Control, Amphia Hospital, PO Box 90158, 4800 RK Breda, The Netherlands Correspondence Bram M. W. Diederen bramdiederen{at}gmail.com Received 6 December 2005 Accepted 5 January 2006 Legionella pneumonia can be difficult to diagnose. Existing laboratory tests all have shortcomings, especially the ability to diagnose all Legionella spp. at an early stage. Detection of Legionella DNA in serum can be a valuable tool for the diagnosis of Legionnaires' disease (LD). This report describes two patients with LD diagnosed by PCR using serum samples. In addition, quantification of L. pneumophila DNA using real-time PCR during the course of illness was carried out. The results obtained mirrored both the clinical condition and C-reactive protein values during the course of the illness. Quantification of Legionella DNA in serum using real-time PCR could be a valuable tool to monitor the effects of antimicrobial therapy in patients with LD. Abbreviations: CAP, community-acquired pneumonia; CRP, C-reactive protein; ICU, intensive care unit; LD, Legionnaires' disease.