[嗜肺军团菌血清群4引起的军团病伴急性肾衰竭]

[Legionnaires' disease with acute renal failure caused by Legionella pneumophilla serogroup 4].

作者信息

Hase Isano, Chibana Kazuyuki, Ohara Tetsuya, Takizawa Hidenori, Furihata Tomoe, Yamada Issei, Fukushima Yasutugu, Ishii Yoshiki, Fukuda Takeshi, Koide Michio, Saitou Atsushi

机构信息

Pulmonary Medicine and Clinical Immunology Dokkyo University School of Medicine, Division of Infetious Disease, Department of Internal Medicine.

出版信息

Nihon Kokyuki Gakkai Zasshi. 2005 Nov;43(11):678-82.

PMID:16366367

Abstract

A 77-year-old man who had fever and chest pain was admitted to a neighboring hospital on a diagnosis of pneumonia. Chest X-ray film finding deteriorated despite treatment with 2 g cefotaxime per day. Because of accompanying acute renal failure, he was transferred to our hospital. Hemodialysis with intravenous administration of erythromycin and meropenem resulted in recovery from acute renal failure, and his general condition improved. Because of liver dysfunction, erythromycin was changed to pazufloxacin. Although he was negative for Legionella urinary antigen determined with a rapid assay kit, Binax NOW, his serum titer for Legionella pneumophila serogroup 4 was elevated. Finally, a diagnosis of Legionnaires' disease caused by Legionella pneumophila serogroup 4 was established.

摘要

一名77岁男性，因发热和胸痛被诊断为肺炎而入住附近医院。尽管每天使用2克头孢噻肟治疗，但胸部X光片检查结果仍恶化。由于伴有急性肾衰竭，他被转至我院。静脉注射红霉素和美罗培南并进行血液透析后，急性肾衰竭得以恢复，其一般状况有所改善。由于肝功能障碍，将红霉素更换为帕珠沙星。尽管使用快速检测试剂盒Binax NOW检测军团菌尿抗原呈阴性，但他嗜肺军团菌血清型4的血清滴度升高。最终，确诊为由嗜肺军团菌血清型4引起的军团病。