6.++Group+Conclusion

Group Conclusion (200-300 words) :


 * Simone King:**

In conclusion the Patient can be diagnosed with legionnaires disease. It has been caused by an infection of the gram negative bacteria l. pneumophila. The patient has acquired the infection by inhaling the aerosols from a contaminated water source and it seems to be community acquired infection. Legionella are gram negative bacilli which do not grow on routine media used in Bacteriology. It requires complex nutritional requirements present in buffered charcoal yeast extract. The growth of the patients infectious agent on the BCYE plate is characteristic of l.pneumophila. The unretained crystal violet dye on the gram staining of the bronchial wash showed the agent to be gram negative which is also another characteristic of l. Pneumophila.

Legionnaire Pneumophila is spread through contact with contaminated water vapour,enters the host cell and avoids detection. Then the immune system through IL-8 recruits macrophages which take up legionella through phagocytosis. This integrates into the phagosome and starts secreting signalling proteins/effectors blocking maturation of the phagosome. Vesicles migrate to the area where GTPase is expressed surrounding legionella and fuse with the phagosome. Ribosomes containing legionella are recruited around the phagosome allowing legionella to be hidden from the immune system and proliferation occurs. It lyses the host cell causing cell death and destruction upon release.
 * Ahmed Abdalla:**


 * Nafie:**

Legionella disease is a leading cause of pneumonia, the disease does not spread from one to other but widely spread in nature as it lives in ponds and water. The outbreak takes place from a purpose built system in which a temperature is warm, and can encourage the growth of bacteria, this occurs mainly in cooling water, evaporative condenser and spas. Most of the outbreak in the community that took place in the UK is linked to installation instance cooling water. In other to prevent the spreading of the disease places or organisation should manage these systems and conform to the regulations in maintain and treating water system properly, as the incidence of the disease is depending on the quantity of water reservoir contamination, and also the intensity of the patient exposure to that water and the susceptibility of the host.

= = In general, the symptoms of Legionnaires disease have several symptoms and are often variable, begins within 2 to 10days after being exposed to bacteria in which the symptoms disappears without being treated and causing any further problems.
 * Ofure Osaigbovo: **


 * Gina Murison:**

The patient 3 days previously complained of fever,malaise and respiratory problems. Amantadine was administered which is used in the treatment of influenza (Ison,M,2011). The patients symptoms progressively got worse and was administered to hospital with bilateral pneumonia. As legionella pneumophilia can present with flu-like symptoms this indicated that the patient was suffering from Legionella pneumophila. As the patient is also suffering from multi-system failure as a results of pnemonia he should be treated with antimicrobials intraveneously with assisted breathing or oxygen being used to help aid the patients recovery. As you don't want to risk resistance to the antimicrobials a cocktail of drugs may work better and give greater results for recovery. Antimicrobials will treat L.pneumophila quickly and efficiently and the patient should then make a full recovery.


 * Ison,M, (2011), //Antivirals and Resistance: Influenza Virus,// Current opinion in Virology 1: 563-57

=** Group Conclusion (overall): **=

As a group we were provided with a gram stain showing gram negative bacteria and also an image of the bacteria growing on buffered charcoal yeast extract. Along with the patient symptoms of fever, malaise and especially respiratory problems, the patient was diagnosed with legionnaire’s disease caused by legionella pneumophila. Legionnaire Pneumophila is spread through contact with contaminated water vapour,enters the host cell and avoids detection. Then the immune system through IL-8 recruits macrophages which take up legionella through phagocytosis. This integrates into the phagosome and starts secreting signalling proteins/effectors blocking maturation of the phagosome. Vesicles migrate to the area where GTPase is expressed surrounding legionella and fuse with the phagosome. Ribosomes containing legionella are recruited around the phagosome allowing legionella to be hidden from the immune system and proliferation occurs. It lyses the host cell causing cell death and destruction upon release. It is most commonly contracted in middle aged to elderly patients in developed countries. Various symptoms are caused by legionnaires disease such as fever, vomiting, shortness of breath along with muscle pains which present 2- 10 days after exposure to L.Pneumophila. Due to the severity of the patients symptoms leading to multi-system failure, antimicrobials should be administered intravenously and assisted breathing or oxygen should be used to aid recovery. Using a cocktail of drugs should be used to block resistance from occurring. Following treatment the patient should have no lasting effects and will recover fully.