Nishimoto Takeshi, Yamahara Kunihiro, Konishi Hiroki
Department of Respiratory Medicine, Kishiwada Tokushukai Hospital.
Kansenshogaku Zasshi. 2003 Sep;77(9):682-6. doi: 10.11150/kansenshogakuzasshi1970.77.682.
A 52-year-old man was admitted to our hospital because of fever and dyspnea. Chest X-ray film showed infiltrative shadows in the right lower lung fields and serum creatinine was 6.7 mg/dl. The patient was diagnosed as pneumonia complicated with acute renal failure. He was treated with antimicrobial therapy. However he developed respiratory failure and exhibited mental confusion. Legionnaires' disease was suspected, because pneumonia was found to be associated with multiple organ dysfunction. We started treatment with intravenous administration of minocycline and continuous hemodiafiltration and his condition had been rapidly improved. We diagnosed this case as legionnaires' disease due to the positive of urinary Legionella pneumophila serogroup 1 antigen. Since the cases of legionnaires' disease with acute renal failure are serious, prompt diagnosis and adequate treatment are essential.
一名52岁男性因发热和呼吸困难入院。胸部X光片显示右下肺野有浸润性阴影,血清肌酐为6.7mg/dl。该患者被诊断为肺炎合并急性肾衰竭。给予抗菌治疗。然而,他出现了呼吸衰竭并伴有精神错乱。由于发现肺炎与多器官功能障碍有关,怀疑为军团病。开始静脉注射米诺环素并持续进行血液透析滤过治疗,其病情迅速改善。因尿嗜肺军团菌血清1型抗原检测呈阳性,将该病例诊断为军团病。鉴于军团病合并急性肾衰竭的病例病情严重,及时诊断和适当治疗至关重要。