Winn W C, Glavin F L, Perl D P, Keller J L, Andres T L, Brown T M, Coffin C M, Sensecqua J E, Roman L N, Craighead J E
Arch Pathol Lab Med. 1978 Jul;102(7):344-50.
Fourteen fatal cases from the 1977 Vermont outbreak of Legionnaires' disease have been analyzed. Serious underlying diseases were present in all patients. The only consistent lesions were in the lungs. Bronchopneumonia was present in all cases and was confluent in most. No lobe of the lung was preferentially involved and consolidation was usually bilateral. Abscesses were evident macroscopically in only two cases. Microscopically, there was an extensive alveolar infiltrate of polymorphonuclear neutrophils and macrophages. Lysis of the inflammatory cells was frequently present and was associated with an increased number of bacteria. Coagulative necrosis of lung was present in a few cases, and the possibility of a bacterial toxin must be considered. Bacteria were well stained by the Dieterle stain and appeared Gram-negative in tissue imprints from the unfixed lung.
对1977年佛蒙特州军团病暴发中的14例死亡病例进行了分析。所有患者均存在严重的基础疾病。唯一一致的病变位于肺部。所有病例均有支气管肺炎，多数病例为融合性。没有肺叶有优先受累情况，实变通常为双侧性。仅两例在宏观上可见脓肿。显微镜下，有广泛的多形核中性粒细胞和巨噬细胞肺泡浸润。炎症细胞溶解频繁出现，并与细菌数量增加有关。少数病例存在肺凝固性坏死，必须考虑细菌毒素的可能性。细菌经Dieterle染色染色良好，在未固定肺的组织印片中呈革兰氏阴性。
