Suzuki Kazue, Tachibana Akio, Hatakeyama Shinobu, Yamaguchi Keizo, Tateda Kazuhiro
Department of Respiratory Disease, Yaizu Municipal General Hospital.
Nihon Kokyuki Gakkai Zasshi. 2002 Apr;40(4):282-6.
To study the clinical characteristics of community-acquired Legionella pneumonia, we carried out a study of 8 patients (7 men and a woman; mean age, 68.4 years) with Legionella pneumonia at Yaizu Municipal General Hospital between 1996 and 1999. We surmised that the sources of infection were travel or a hot spring, or both, in 4 cases, occupation (plumbing and fish market work) in 2 cases and gardening in one. All patients had fever above 38 degrees C, hypoxemia and a high inflammation reaction of. The initial findings of chest radiography were air-space consolidation in all cases, lobar pneumonia in 7, and unilateral shadows in 6, similar to those seen in acute Streptococcus pneumoniae pneumonia. Diagnostic methods were urinary antigen in 4 of 7 cases, bacterial culture in 4 of 6 cases (L. pneumophila, 3 cases; L. longbeachae, 1 case), polymerase chain reaction on the serum in 2 of 5 cases, and serum antibody in 1 of 7 cases. Urinary antigen was most useful for early diagnosis. The clinical presentation and the initial chest radiography findings were non-specific, despite the high fever, severe hypoxemia, and radical progression within a few days.
为研究社区获得性军团菌肺炎的临床特征，我们对1996年至1999年间在八代市立综合医院收治的8例军团菌肺炎患者（7例男性，1例女性；平均年龄68.4岁）进行了研究。我们推测，4例患者的感染源为旅行或温泉，或两者皆有；2例为职业（管道工和鱼市工作）感染；1例为园艺工作感染。所有患者均有体温高于38℃、低氧血症及高度炎症反应。胸部X线检查的初始表现均为肺实变，7例为大叶性肺炎，6例为单侧阴影，与急性肺炎链球菌肺炎相似。诊断方法包括：7例中有4例采用尿抗原检测，6例中有4例进行细菌培养（嗜肺军团菌3例，长滩军团菌1例），5例中有2例采用血清聚合酶链反应检测，7例中有1例采用血清抗体检测。尿抗原检测对早期诊断最有用。尽管患者高热、严重低氧血症且在数天内病情急剧进展，但其临床表现及胸部X线检查初始表现均无特异性。
