Miyashita N, Fukano H, Hara H, Hara F, Nakajima T, Niki Y, Matsushima T
Department of Internal Medicine and Surgery, Kurashiki Daiichi Hospital.
Nihon Kokyuki Gakkai Zasshi. 2001 Jun;39(6):446-51.
A 49-year-old man visited our hospital complaining of a continuous high-grade fever and cough which had appeared during his stay in Indonesia. He was admitted on the same day because his laboratory data showed marked inflammatory changes and his chest radiograph revealed an infiltrative shadow in the right upper lung field. Initial treatment with beta-lactams was not effective and both his symptoms and his chest radiograph worsened. However, treatment with erythromycin clearly had an effect. Then, we carried out several tests for detection of atypical pathogens including Mycoplasma and Chlamydia. Finally, the case was diagnosed as one of Coxiella burnetii pneumonia because the DNA of C. burnetii was detected from his sera and seroconversion of C. burnetii--specific antibody was observed among paired serum samples. C. burnetii is one of the most commonly recognized pathogens among community-acquired pneumonias in Western countries, but in Japan, reports of community-acquired C. burnetii pneumonia have been rare. This difference may be due to the features of Q fever, in which there are large differences in frequency and form from country to country and among areas of the same country. Surveillance of C. burnetii pneumonia in Japan and different area will be required.
一名49岁男性因在印度尼西亚停留期间出现持续高热和咳嗽症状前来我院就诊。因其实验室检查数据显示有明显炎症改变，胸部X线片显示右上肺野有浸润性阴影，于当日入院。最初使用β-内酰胺类药物治疗无效，其症状和胸部X线片均恶化。然而，使用红霉素治疗明显有效。随后，我们进行了多项检测以检测包括支原体和衣原体在内的非典型病原体。最终，该病例被诊断为贝纳柯克斯体肺炎，因为从其血清中检测到了贝纳柯克斯体的DNA，并且在配对血清样本中观察到了贝纳柯克斯体特异性抗体的血清学转换。贝纳柯克斯体是西方国家社区获得性肺炎中最常见的病原体之一，但在日本，社区获得性贝纳柯克斯体肺炎的报道很少。这种差异可能归因于Q热的特点，其在不同国家以及同一国家的不同地区在发病率和形式上存在很大差异。日本及不同地区需要对贝纳柯克斯体肺炎进行监测。
