Internal Medicine, University of Toledo, Toledo, USA.
Pulmonology and Critical Care Medicine, University of Toledo, Toledo, USA.
Lupus. 2021 May;30(6):1010-1012. doi: 10.1177/0961203321990102. Epub 2021 Jan 26.
Legionnaire's disease (LD) is most commonly caused by Legionella pneumophila (L. pneumophila). In immunocompromised patients LD can cause necrosis of the lung parenchyma with abscess formation and cavitation. Systemic lupus erythematosus (SLE) is an autoimmune disorder with features of both primary and secondary immunodeficiency. SLE patients often develop pulmonary abnormalities, but rarely develop lung cavitations. We report a case of cavitary pneumonia caused by L. pneumophila in a 64-year-old female patient with SLE. We also highlight reasons why SLE patients are more prone to L. pneumophila infections. The importance of using correct diagnostic methods for recognizing and treating such infections is also discussed, as mistreatment of cavitary lesions in SLE patients with steroid therapy can have fatal outcomes as the infectious process can significantly worsen.
军团病(LD)最常见的病因是嗜肺军团菌(L. pneumophila)。在免疫功能低下的患者中,LD 可导致肺实质坏死、脓肿形成和空洞。系统性红斑狼疮(SLE)是一种自身免疫性疾病,具有原发性和继发性免疫缺陷的特征。SLE 患者常发生肺部异常,但很少发生肺部空洞。我们报告了一例由嗜肺军团菌引起的 64 岁女性 SLE 患者的空洞性肺炎。我们还强调了 SLE 患者更容易感染嗜肺军团菌的原因。讨论了正确使用诊断方法识别和治疗此类感染的重要性,因为在 SLE 患者中,由于感染过程可能显著恶化,类固醇治疗会导致空洞病变的不当处理,从而产生致命的后果。