Beaty H N, Miller A A, Broome C V, Goings S, Phillips C A
JAMA. 1978 Jul 14;240(2):127-31.
Thirty-two confirmed and 24 highly probable cases of Legionnaires' disease occurred in Vermont between May 1 and Oct 15, 1977. Confirmed cases had positive results for direct fluorescent antibody testing of lung tissue or fourfold rise in antibody titer. Highly probable cases had one elevated titer (greater than or equal to 1:256) and a compatible illness. Forty-eight (86%) had underlying chronic disease, and 22 (39%) were immunocompromised. Prominent early symptoms were fever, cough, chills, and malaise. All but one patient had verified pneumonia. Courses ranged from a pneumonia not requiring hospitalization to respiratory failure necessitating support with mechanical ventilation. Seventeen patients died. Although the clinical presentation was variable, rapid development of high fever and leukocytosis together with negative cultures of lower respiratory tract secretions strongly suggested the diagnosis in an epidemic setting.
1977年5月1日至10月15日期间，佛蒙特州出现了32例确诊的军团病病例和24例极有可能的病例。确诊病例的肺组织直接荧光抗体检测结果呈阳性，或抗体滴度呈四倍升高。极有可能的病例有一次滴度升高（大于或等于1:256）且患有相符的疾病。48例（86%）有潜在慢性病，22例（39%）免疫功能低下。突出的早期症状为发热、咳嗽、寒战和不适。除一名患者外，所有患者均确诊为肺炎。病程从无需住院治疗的肺炎到需要机械通气支持的呼吸衰竭不等。17名患者死亡。尽管临床表现各异，但在流行环境中，高热和白细胞增多的快速发展以及下呼吸道分泌物培养阴性强烈提示了诊断。
