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使用Ribotest®军团菌进行多次尿抗原检测未检出的军团菌肺炎

Legionella Pneumonia Undetected by Repeated Urinary Antigen Testing With Ribotest® Legionella.

作者信息

Murakami Yasushi, Morosawa Mika, Nozaki Yasuhiro, Takesue Yoshio

机构信息

Department of Respiratory Medicine, Tokoname City Hospital, Tokoname, JPN.

Department of Clinical Infectious Diseases, Tokoname City Hospital, Tokoname, JPN.

出版信息

Cureus. 2024 Nov 19;16(11):e74035. doi: 10.7759/cureus.74035. eCollection 2024 Nov.

DOI:10.7759/cureus.74035
PMID:39712728
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11661902/
Abstract

This report presents a patient with pneumonia (LP), initially presented with fever and mild hypoxemia, with subsequent progression to severe pneumonia during hospitalization. Despite multiple negative urinary antigen tests using Ribotest , the diagnosis was confirmed via the loop-mediated isothermal amplification method of lower respiratory tract secretions. This case highlights the diagnostic limitations of Ribotest and emphasizes the importance of a comprehensive diagnostic strategy, incorporating nucleic acid amplification tests or culture in suspected patients with LP. Early recognition of these diagnostic challenges is critical for optimizing patient outcomes.

摘要

本报告介绍了一名肺炎患者（军团菌肺炎），最初表现为发热和轻度低氧血症，住院期间病情进展为重症肺炎。尽管使用Ribotest进行的多次尿抗原检测结果均为阴性，但通过对下呼吸道分泌物采用环介导等温扩增法确诊了该病。该病例凸显了Ribotest的诊断局限性，并强调了综合诊断策略的重要性，即在疑似军团菌肺炎患者中采用核酸扩增检测或培养。尽早认识到这些诊断挑战对于优化患者预后至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/298d/11661902/b6548522bc53/cureus-0016-00000074035-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/298d/11661902/71d6c87f7555/cureus-0016-00000074035-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/298d/11661902/35fb4c14ef93/cureus-0016-00000074035-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/298d/11661902/b6548522bc53/cureus-0016-00000074035-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/298d/11661902/71d6c87f7555/cureus-0016-00000074035-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/298d/11661902/35fb4c14ef93/cureus-0016-00000074035-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/298d/11661902/b6548522bc53/cureus-0016-00000074035-i03.jpg

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本文引用的文献

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Severe Legionnaires' disease.重症军团病
Ann Intensive Care. 2024 Apr 2;14(1):51. doi: 10.1186/s13613-024-01252-y.
2
Sputum colour: An indicator of pneumonia.痰液颜色：肺炎的一项指标。
Respirol Case Rep. 2024 Feb 28;12(3):e01312. doi: 10.1002/rcr2.1312. eCollection 2024 Mar.
3
Legionellosis on the rise: A scoping review of sporadic, community-acquired incidence in the United States.军团病发病率上升：美国散发性、社区获得性发病的范围综述。
Epidemiol Infect. 2023 Jul 28;151:e133. doi: 10.1017/S0950268823001206.
4
A case of severe pneumonia caused by with positive results by a urinary antigen detection kit.一例由[具体病原体未给出]引起的重症肺炎，尿抗原检测试剂盒检测结果呈阳性。
Ther Adv Infect Dis. 2023 Jun 14;10:20499361231179863. doi: 10.1177/20499361231179863. eCollection 2023 Jan-Dec.
5
Severe Legionella Pneumonia in Which Serial Testing by Ribotest Legionella was Useful for the Diagnosis.严重军团菌肺炎中，Ribotest 军团菌的连续检测对诊断很有用。
Intern Med. 2023 Oct 15;62(20):2989-2993. doi: 10.2169/internalmedicine.0766-22. Epub 2023 Mar 8.
6
Clinical and Laboratory Diagnosis of Legionella Pneumonia.军团菌肺炎的临床与实验室诊断
Diagnostics (Basel). 2023 Jan 12;13(2):280. doi: 10.3390/diagnostics13020280.
7
Incidence and risk factors associated with progression to severe pneumonia among adults with non-severe Legionella pneumonia.非重症军团菌肺炎成人患者进展为重症肺炎的发病率及相关危险因素。
Acute Crit Care. 2022 Nov;37(4):543-549. doi: 10.4266/acc.2022.00521. Epub 2022 Oct 21.
8
Diagnostic accuracy of urinary antigen tests for legionellosis: A systematic review and meta-analysis.尿路感染症病原体检测试剂盒诊断尿路感染症的准确性：系统评价与荟萃分析。
Respir Investig. 2022 Mar;60(2):205-214. doi: 10.1016/j.resinv.2021.11.011. Epub 2021 Dec 28.
9
National survey of physicians in Japan regarding their use of diagnostic tests for legionellosis.日本全国范围内对医生使用军团病诊断检测的调查。
J Infect Chemother. 2022 Feb;28(2):129-134. doi: 10.1016/j.jiac.2021.12.008. Epub 2021 Dec 20.
10
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J Infect Chemother. 2021 Oct;27(10):1533-1535. doi: 10.1016/j.jiac.2021.05.019. Epub 2021 Jun 2.