Bronchial lavage and transbronchial lung biopsy in the diagnosis of Legionnaires' disease.

Legionnaires' disease is increasingly recognised as a cause of community acquired pneumonia.' Although there are no controlled trials of antimicrobial chemotherapy in legionnaires' disease, an early bacteriological diagnosis will confirm the need for treatment directed at Legionella or will redirect treatment should another pathogen be isolated. Serological tests provide only a retrospective diagnosis; while rapid antigen detection (for example, by ELISA or latex agglutination with urine samples2), although permitting early diagnosis, does not allow isolation of the organism. We report three cases of legionella pneumonia where the organism was isolated from material obtained during life by bronchoscopy.