Kato Hirofumi, Murata Kengo, Kashiyama Tetsuya, Okamoto Syoichi, Mikura Shinichiro, Takamori Mikio
Department of Pulmonary Medicine, Tokyo Metropolitan Tama Medical Center.
Kansenshogaku Zasshi. 2013 May;87(3):375-9. doi: 10.11150/kansenshogakuzasshi.87.375.
A 54-year-old man presented with fever and dyspnea about a week before his admission. We diagnosed Legionella pneumonia from his chest X-ray imaging which showed bilateral lobe consolidation excluding the left upper lobe, and his sputum culture yielded Legionella pneumophilla serogroup 1. Combination therapy with levofloxacin and rifampin was started on admission. However, the patient developed severe acute respiratory distress syndrome (ARDS) and then extracorporeal membrane oxygenation (ECMO) was initiated on the 2nd day. His respiratory status gradually improved after that and he was weaned from ECMO on the 7th day. He was discharged without sequelae on the 36th day. The outcome suggests that use of ECMO should be considered for patients with severe Legionella pneumonia.
一名54岁男性在入院前约一周出现发热和呼吸困难。通过胸部X线成像诊断为军团菌肺炎，其显示双侧肺叶实变，但左肺上叶除外，且痰培养检出嗜肺军团菌血清1型。入院时开始使用左氧氟沙星和利福平联合治疗。然而，患者发展为严重急性呼吸窘迫综合征（ARDS），随后在第2天开始进行体外膜肺氧合（ECMO）治疗。此后其呼吸状况逐渐改善，并于第7天撤机。他在第36天出院，无后遗症。该结果表明，对于严重军团菌肺炎患者应考虑使用ECMO。
