Sugihara Eiichiro, Dambara Takashi, Aiba Miyoji, Okamoto Masaki, Yonemitsu Junko, Sonobe Satoshi, Koga Hideyuki, Inui Akihiro, Hada Naoko, Matsumoto Naomi, Goto Yoko, Naito Toshio, Isonuma Hiroshi, Hayashida Yasuo
Department of General Medicine, Juntendo University School of Medicine, Tokyo.
Intern Med. 2007;46(8):461-5. doi: 10.2169/internalmedicine.46.6084. Epub 2007 Apr 17.
Legionella spp are well recognized as one of the etiologic factor in pneumonia, but it is difficult to distinguish the clinical features of Legionella infection from pneumonia due to other causes. The objective of the present study was to examine the clinical characteristics of community-acquired Legionella pneumonia in elderly patients. We reviewed the clinical, laboratory and radiographic findings in 8 patients diagnosed as having pneumonia caused by Legionella. The diagnosis was confirmed by the presence of urinary antigen, bacterial culture, polymerase chain reaction (PCR) and serum antibody. There were 6 men and 2 women, whose ages ranged from 76 to 85 years. All patients had fever and hypoxia, four patients had respiratory symptoms. The initial chest X-ray findings were varied--consolidation, ground glass opacity, pleural effusion and linear shadow. Urinary antigen was positive in 4 patients, bacterial culture in 2, PCR on the sputum in 3 and serum antibody in 2 patients. As pneumonia caused by Legionella often becomes life-threatening, especially in elderly people, it is imperative to diagnose it at the initial stage. In this study, urinary antigen proved to be the most useful diagnostic means. However, it is important to confirm the diagnosis through plural examinations.
军团菌属被公认为是肺炎的病因之一，但由于其他原因，很难将军团菌感染的临床特征与肺炎区分开来。本研究的目的是探讨老年社区获得性军团菌肺炎的临床特征。我们回顾了8例诊断为军团菌引起的肺炎患者的临床、实验室和影像学检查结果。诊断通过尿抗原、细菌培养、聚合酶链反应（PCR）和血清抗体得以证实。患者中有6名男性和2名女性，年龄在76至85岁之间。所有患者均有发热和缺氧症状，4例患者有呼吸道症状。最初的胸部X线表现多样——实变、磨玻璃影、胸腔积液和线状阴影。4例患者尿抗原阳性，2例细菌培养阳性，3例痰PCR阳性，2例血清抗体阳性。由于军团菌引起的肺炎往往会危及生命，尤其是在老年人中，因此在疾病初期进行诊断至关重要。在本研究中，尿抗原被证明是最有用的诊断方法。然而，通过多种检查来确诊是很重要的。
