Meyer R D, Edelstein P H, Kirby B D, Louie M H, Mulligan M E, Morgenstein A A, Finegold S M
Ann Intern Med. 1980 Aug;93(2):240-3. doi: 10.7326/0003-4819-93-2-240.
During a nosocomial epidemic of Legionnaires' disease, clinical and laboratory observations led to the recognition of remarkable aspects in six patients. Features included two episodes of disease, dual or sequential infections with Legionella pneumophila and other pathogens; transient deafness with erythromycin therapy, and Legionnaires' disease with a pleural effusion but no pulmonary infiltrate. Expectorated sputum culture yielded two serogroups of L. pneumophila in one patient. Cultures of transtracheal and endotracheal aspirates and of blood led to the diagnosis, permitted evaluation of confounding potential pathogens, and confirmed Legionnaires' disease in the absence of seroconversion. Although many manifestations of Legionnaires' disease were quite typical in this outbreak, these additional unusual features expand the spectrum and illustrate the value of rapid diagnostic methods.
在一次医院内军团病流行期间，临床和实验室观察发现了6例患者的显著特征。这些特征包括两次发病、嗜肺军团菌与其他病原体的双重或相继感染；红霉素治疗导致的短暂性耳聋，以及伴有胸腔积液但无肺部浸润的军团病。1例患者咳出的痰液培养出两种嗜肺军团菌血清群。经气管和气管内吸出物及血液培养有助于诊断，可评估潜在的混杂病原体，并在血清转化阴性的情况下确诊军团病。尽管此次疫情中军团病的许多表现相当典型，但这些额外的不寻常特征拓宽了其临床表现谱，并说明了快速诊断方法的价值。
