1976 Philadelphia Legionnaires' disease outbreak States Center for Disease Control and Prevention (CDC) in 2017 only use the term Legionnaires' disease to refer to the serious version with pneumonia. CDC investigators quickly discovered outbreaks of respiratory disease caused by "L. pneumophila" dating back to 1959. An outbreak of what was dubbed Pontiac fever occurred in a health department in Pontiac, Michigan in July 1967. No one died. Although caused by the same bacterium, Pontiac fever is a milder ailment than Legionnaires' disease. Pneumonia is absent in those with Pontiac fever. An outbreak of pneumonia in July–August, 1965, at St. Elizabeths Hospital in Washington, DC, which
Hospital-acquired pneumonia sputum samples and intensive care patients, in whom these bacteria were commonly found. In one observational study, empirical antibiotic treatment that was not according to international treatment guidelines was an independent predictor of worse outcome among HCAP patients. Guidelines from Canada suggest that HCAP can be treated like community-acquired pneumonia with antibiotics targeting Streptococcus pneumoniae, based on studies using blood cultures in different settings which have not found high rates of MRSA or Pseudomonas. Besides prompt antibiotic treatment, supportive measure for organ failure (such as cardiac decompensation) are also important. Another consideration goes to hospital referral; although more severe pneumonia