Hirano Yuichi, Takahashi Sakuma, Inaba Tomoki, Kawai Yusuke, Sakakihara Ichiro, Izumikawa Koichi, Yamamoto Kumiko, Tanaka Shigetomi, Ishikawa Shigenao, Wato Masaki
Department of Gastroenterology, Kagawa Prefectural Central Hospital.
Inflammatory Bowel Disease Center, Kagawa Prefectural Central Hospital.
Nihon Shokakibyo Gakkai Zasshi. 2020;117(11):971-977. doi: 10.11405/nisshoshi.117.971.
A 67-year-old man was diagnosed with ulcerative colitis one year ago. Remission was induced via the oral administration of prednisolone and azathioprine;prednisolone was gradually reduced and discontinued. He maintained remission with azathioprine but developed fever and general malaise and visited the Kagawa Prefectural Central Hospital. Chest radiography and a urinary antigen test revealed Legionella pneumonia. His symptoms reduced immediately after the initiation of levofloxacin. Azathioprine suppresses cellular immunity and may increase the risk of Legionella pneumonia.
一名67岁男性一年前被诊断为溃疡性结肠炎。通过口服泼尼松龙和硫唑嘌呤诱导缓解；泼尼松龙逐渐减量并停用。他使用硫唑嘌呤维持缓解，但出现发热和全身不适，遂前往香川县立中央医院就诊。胸部X线检查和尿抗原检测显示为军团菌肺炎。开始使用左氧氟沙星后，他的症状立即减轻。硫唑嘌呤会抑制细胞免疫，可能会增加患军团菌肺炎的风险。
