Department of Nephrology, National Center for Global Health and Medicine, Japan.
Intern Med. 2020 Aug 1;59(15):1913-1918. doi: 10.2169/internalmedicine.4530-20. Epub 2020 Apr 23.
We herein report a case of fulminant Legionnaires' disease with autopsy findings in a patient on maintenance hemodialysis (HD). Chronic kidney disease is a strong risk factor for Legionnaires' disease, although there have been only a few reports in HD patients. Because most patients on HD are anuric, the use of rapid assay kits to detect antigens in urine samples for the diagnosis of Legionnaires' disease is not always feasible. We suggest the use of clinical predictive tools or the loop-mediated isothermal amplification (LAMP) method, which can be applied for anuric patients, such as those on HD, with pneumonia.
我们在此报告一例维持性血液透析(HD)患者暴发性军团病的病例,并伴有尸检结果。慢性肾脏病是军团病的一个强烈危险因素,尽管在 HD 患者中仅有少数报道。由于大多数 HD 患者无尿,因此使用快速检测试剂盒检测尿液样本中的抗原来诊断军团病并不总是可行。我们建议使用临床预测工具或环介导等温扩增(LAMP)方法,可应用于患有肺炎的无尿患者,如 HD 患者。