Dear Doctor: You can get diarrhea by using water instead of wiper fluid

Key Points:

• Legionnaires’ disease is a pneumonia caused by the bacterium Legionella pneumophilia, primarily spread through inhalation of aerosolized water from contaminated sources like air-conditioning cooling towers and water systems.
• The disease is not typically spread person-to-person and is more common and severe in older adults or those with weakened immune systems.
• Symptoms resemble other pneumonias but often include gastrointestinal issues such as nausea, vomiting, and diarrhea, with certain blood test abnormalities; effective treatment requires antibiotics like clarithromycin, azithromycin, or levofloxacin.
• Windshield wipers can potentially spread Legionnaires’ disease if filled with tap water containing Legionella, as the wipers aerosolize the contaminated water, but using proper wiper fluid eliminates this risk.
• Hydralazine, a drug used for resistant hypertension and heart failure, has no exact substitute and is generally available, though shortages in injectable form exist; patients should consult their doctors and pharmacists for alternatives or mail-order options.