Chang F Y
Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.
J Microbiol Immunol Infect. 1998 Sep;31(3):200-2.
A 52-year-old male had fever, pleuritic chest pain, cough with purulent sputum and hemoptysis for 4 days. The patient had underlying alcoholic cardiomyopathy, cirrhosis of the liver, chronic obstructive lung disease and underwent corticosteroids therapy. Chest radiograph showed round opacities bilaterally. Legionella pneumophila serogroup 5 was identified by direct fluorescent antibody staining and culture from the sputum. Despite intravenous erythromycin and rifampin therapy, he died on the 7th hospital day. The autopsy showed bilateral pulmonary consolidation with abscess formation. Legionnaires' disease should be included in the differential diagnosis if an immunosuppressed patient presents with multilobar opacities on chest radiograph. Specific tests for Legionnaires' disease should be performed.
一名52岁男性发热、胸痛伴胸膜炎、咳嗽并有脓性痰及咯血4天。该患者有酒精性心肌病、肝硬化、慢性阻塞性肺疾病病史，并接受过皮质类固醇治疗。胸部X线片显示双侧有圆形阴影。通过直接荧光抗体染色及痰液培养鉴定出嗜肺军团菌血清5型。尽管给予静脉注射红霉素和利福平治疗，患者在住院第7天死亡。尸检显示双侧肺实变并形成脓肿。如果免疫抑制患者胸部X线片出现多叶阴影，鉴别诊断应包括军团菌病。应进行军团菌病的特异性检查。
