Specimen Requirements

Stability

Days Performed

Sun - Sat

Turnaround Time

7 days

Methodology

Reference Range

Special Info

Patient Preparation: Aseptic preparation of the aspiration/surgical site. Specimens that are contaminated with other organisms will decrease the likelihood of isolating Legionella pneumophila. If culture is positive, identification will be performed at an additional charge. Identification CPT codes that may apply include: 87077, 87153. Antimicrobial susceptibilities are not performed.

Clinical Info

Multiple laboratory methods should be employed to ensure the diagnosis of Legionnaire's Disease (LD), a bacterial pneumonia caused by L. pneumophila (90% of cases) or other Legionella species. Molecular methods are more sensitive than culture for the diagnosis of LD. The PCR assay performed at Cleveland Clinic will not detect disease caused by Legionella species other than L. pneumophila. Culture for Legionella species from respiratory sites is a sensitive (~80 - 90%) method for diagnosing severe, untreated disease, but insensitive (~20%) for the diagnosis of mild disease. Specimens from nonrespiratory sites should not be submitted for Legionella culture unless there is a high index of clinical suscipion to support the request. Urine antigen assays for L. pneumophila serogroup 1 will be in positive in ~90 - 95% of patients with severe disease due to the Pontiac monoclonal subtype of serogroup 1, but positive in only 50% of these patients with mild disease. The urine antigen assay is unreliable for the diagnosis of severe LD caused by L. pneumophila other than serogroup 1 or a different Legionella species (detects less than 5 - 40% of cases).