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[使用持续气道正压通气设备后发生的军团菌肺炎]

[Legionella pneumonia after the use of CPAP equipment].

作者信息

Stolk Jaap M, Russcher Anne, van Elzakker Erika P M, Schippers Emile F

机构信息

HagaZiekenhuis, Den Haag.

出版信息

Ned Tijdschr Geneeskd. 2016;160:A9855.

Abstract

Continuous positive airway pressure (CPAP) equipment can be colonised by Legionellae and might cause Legionella pneumonia in the user. However, there is no reported case of Legionella pneumonia related to CPAP equipment in which an identical Legionella was found in both the patient and the CPAP equipment. A 51-year-old man came to the Emergency Department with fever, confusion and dyspnoea that had been present for 3 days. His medical history included obstructive sleep apnoea, for which he had been using CPAP therapy at home for 10 weeks. The CPAP equipment showed signs of poor maintenance. Chest X-ray revealed a pulmonary consolidation. Laboratory investigation resulted in a positive urine antigen test for Legionella. Water from the CPAP equipment and sputum from the patient revealed Legionella pneumophila. Serotyping and sequence-based typing showed an identical L. pneumophila serotype 1 ST37. It is important to be aware that CPAP equipment can be colonised with Legionellae and might cause Legionella pneumonia. It is therefore necessary to ask about CPAP therapy in a patient with community-acquired pneumonia.

摘要

持续气道正压通气(CPAP)设备可能会被军团菌定植,并可能导致使用者发生军团菌肺炎。然而,尚无关于CPAP设备相关军团菌肺炎的报道病例,即在患者和CPAP设备中发现相同的军团菌。一名51岁男性因发热、意识模糊和呼吸困难3天前来急诊科就诊。他的病史包括阻塞性睡眠呼吸暂停,为此他在家中使用CPAP治疗已有10周。CPAP设备显示出维护不佳的迹象。胸部X线显示肺部实变。实验室检查结果显示军团菌尿抗原检测呈阳性。CPAP设备中的水和患者的痰液检测出嗜肺军团菌。血清分型和基于序列的分型显示为相同的嗜肺军团菌血清型1 ST37。认识到CPAP设备可能被军团菌定植并可能导致军团菌肺炎很重要。因此,对于社区获得性肺炎患者,有必要询问其是否接受CPAP治疗。

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