Legionnaires’ disease

Legionella is a type of bacterium found naturally in freshwater environments, like lakes and streams. It can become a health concern when it grows and spreads in human-made water systems such as building premise plumbing and cooling towers (structures that contain water and a fan as part of centralized air-cooling systems for building or industrial processes). Legionella can continue to persist in the water system unless proper steps are taken to prevent the growth of bacteria.

Outbreaks of Legionnaires’ disease are often associated with large or complex potable water systems.

Urine antigen testing via immunochromatography is a widely available, quick diagnostic test with a > 85% sensitivity and > 99% specificity for Legionella pneumophila. However, the available assay only tests for L pneumophila serogroup 1

Antimicrobial therapy is dictated by the severity of the infection, underlying conditions or allergies, antimicrobial resistance, and medication availability. Some guidelines and studies suggest that macrolides may be superior to fluoroquinolones. Parenteral therapy is the preferred initial treatment modality; patients should be transitioned to oral therapies with clinical improvement.

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Trigeminal neuralgia (tic douloureux)

"Imagine your face has a super-sensitive alarm system—the trigeminal nerve. It’s supposed to quietly handle sensations like touch, warmth, or a gentle breeze. But with trigeminal neuralgia, that system goes haywire. Suddenly, even mild triggers like brushing your teeth, talking, or a light wind can set off intense, electric-shock-like pain. It’s like your nerve’s alarm is stuck on high alert, firing off pain signals when it shouldn’t.

The cause? Often, a blood vessel pressing on the nerve—or sometimes multiple sclerosis or other conditions—can irritate or damage the nerve’s protective covering.

Historically, trigeminal neuralgia was first described in the 17th century by physician Johannes Bausch. It was later more clearly defined in the 18th century by John Fothergill, who provided one of the earliest clinical descriptions, leading to the term “Fothergill’s disease.” The condition has long been recognized as one of the most severe forms of facial pain in medical literature."

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