Belikov E S, Trifonova A G, Kotsurak L M, Belikov I E, Mikhaĭlova D O
Zh Mikrobiol Epidemiol Immunobiol. 2008 Mar-Apr(2):105-7.
Data on postmortem examination of five patients deceased during Legionnaires' outbreak in town Verkhnyaya Pyshma are presented in the article. Feature of course of the disease was severe affection of the lungs with development of toxic shock. Pathomorphological picture in lungs was characterized by polymorphism, presence of shock reaction and ventilator-associated pneumonia (atelectases, distelectases, tracheobronchitis). In autopsy material from four fatal cases Legionella pneumophila serogroup 1 was detected. Causative agent of pneumonia was not determined in one fatal case although comparison of clinical and morphological characteristics of this case with other four cases as well as detection of Gram-negative bacillus in alveolar macrophages allowed to consider this case of pneumonia as caused by Legionella. In studied fatal cases postmortem diagnoses were ascertained in which main disease was bilateral pneumonia caused by Legionella pneumophila serogroup 1 complicated by toxic shock.
本文介绍了在韦尔赫尼亚亚皮什马镇军团病暴发期间死亡的5例患者的尸检数据。该病病程的特点是肺部受到严重影响并发展为中毒性休克。肺部的病理形态学表现具有多态性，存在休克反应和呼吸机相关性肺炎（肺不张、肺膨胀不全、气管支气管炎）。在4例致命病例的尸检材料中检测到嗜肺军团菌血清1型。1例致命病例中未确定肺炎病原体，尽管将该病例与其他4例病例的临床和形态学特征进行比较以及在肺泡巨噬细胞中检测到革兰氏阴性杆菌，使得该例肺炎被认为是由军团菌引起的。在所研究的致命病例中确定了尸检诊断，其中主要疾病是由嗜肺军团菌血清1型引起的双侧肺炎并伴有中毒性休克。
