Matsumoto N, Mukae H, Yamashita S, Iiboshi H, Hiratsuka T, Katoh S, Matsukura S
Third Department of Internal Medicine, Miyazaki Medical College.
Kansenshogaku Zasshi. 2000 Nov;74(11):989-93. doi: 10.11150/kansenshogakuzasshi1970.74.989.
A 67-year-old male was admitted to our hospital due to a high fever with abnormal shadows on chest X-ray films. On admission, his laboratory data showed hyponatremia, rhabdomyolysis and liver dysfunction. Encephalopathy, acute renal failure and respiratory failure developed, despite fluid management and antimicrobial therapy. His condition worsened rapidly in a few days enough to require mechanical ventilation. Legionnaires' disease was suspected, because pneumonia was found to be associated with multiple organ dysfunction. Intravenous erythromycin and methylprednisolone were administered. The patient's condition was rapidly improved, although he needed hemodialysis for 30 days. Later, indirect fluorescent antibody testing of the patient's serum against Legionella pneumophila was definitely positive (1:1024). We reported the first case of severe Legionnaires' disease in Miyazaki Prefecture, Japan.
一名67岁男性因高热且胸部X光片出现异常阴影而入住我院。入院时，他的实验室检查数据显示低钠血症、横纹肌溶解和肝功能障碍。尽管进行了液体管理和抗菌治疗，仍出现了脑病、急性肾衰竭和呼吸衰竭。由于发现肺炎与多器官功能障碍有关，怀疑为军团病。给予静脉注射红霉素和甲基强的松龙。尽管患者需要进行30天的血液透析，但病情迅速好转。后来，患者血清针对嗜肺军团菌的间接荧光抗体检测呈强阳性（1:1024）。我们报告了日本宫崎县首例重症军团病病例。
