Ito Isao, Naito Junko, Kadowaki Seizo, Mishima Michiaki, Ishida Tadashi, Hongo Toshiharu, Ma Ling, Ishii Yoshikazu, Matsumoto Tetsuya, Yamaguchi Keizo
Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University.
Intern Med. 2002 Oct;41(10):859-63. doi: 10.2169/internalmedicine.41.859.
A 59-year-old man developed pneumonia 9 days after bathing in a hot spring spa. Bilateral shadows on his chest radiograph rapidly progressed after admission. He was successfully treated with erythromycin and rifampicin. Legionella pneumophila serogroup 6 was recovered from an intratrachial specimen and a significant elevation was observed in a paired indirect fluorescent antibody to Legionella. Persistent slight fever and chest rentogenographic shadows resolved after administering low-dose prednisolone to treat organizing pneumonia shown by transbronchial lung biopsy. The same serotype of Legionella was recovered from the water of the hot spring spa where the man had bathed. When the extracted DNA of these two strains showed identical restriction fragments by pulsed-field gel electrophoresis, we had direct evidence that hot spring spas can be a source of Legionella pneumonia.
一名59岁男性在温泉浴场沐浴9天后患上肺炎。入院后其胸部X光片上的双侧阴影迅速进展。他接受红霉素和利福平治疗后康复。从气管内标本中分离出嗜肺军团菌血清群6，并且在针对军团菌的配对间接荧光抗体检测中观察到显著升高。经支气管肺活检显示存在机化性肺炎，给予低剂量泼尼松龙治疗后，持续的低热和胸部影像学阴影消失。在该男子沐浴的温泉浴场的水中也分离出相同血清型的军团菌。当通过脉冲场凝胶电泳显示这两个菌株的提取DNA具有相同的限制性片段时，我们有了直接证据证明温泉浴场可能是军团菌肺炎的一个来源。
