Brusch John L
Medical Department, Cambridge Health Alliance, 1493 Cambridge Street, Cambridge, MA 02139, USA; Division of Infectious Diseases, Cambridge Health Alliance, 1493 Cambridge Street, Cambridge, MA 02139, USA; Ambulatory Medicine, Cambridge Health Alliance, 1493 Cambridge Street, Cambridge, MA 02139, USA; Medicine, Harvard Medical School, 25 Shattuck Street, Boston, MA 02155, USA.
Infect Dis Clin North Am. 2017 Mar;31(1):69-80. doi: 10.1016/j.idc.2016.10.006.
Most cardiac infections with Legionella are secondary to bacteremias arising from a pulmonary focus. Other possible sites of origin are infected sternotomy wounds or equipment contaminated by Legionella spp. Legionella endocarditis is truly a "stealth" infection, with almost no hallmarks of bacterial endocarditis. The key step in making the diagnosis of Legionella endocarditis is for the physician to be aware of the clinical causes of culture-negative infective endocarditis and to include Legionella cardiac involvement in this differential. Many times the issue of endocarditis arises only on examination of resected valvular material.
大多数由军团菌引起的心脏感染继发于肺部病灶引发的菌血症。其他可能的感染源部位是感染的胸骨切开伤口或被军团菌属污染的设备。军团菌性心内膜炎确实是一种“隐匿性”感染，几乎没有细菌性心内膜炎的特征。诊断军团菌性心内膜炎的关键步骤是医生要了解培养阴性感染性心内膜炎的临床病因，并将军团菌累及心脏纳入鉴别诊断。很多时候，心内膜炎问题仅在检查切除的瓣膜组织时才出现。
