Kirby B D, Snyder K M, Meyer R D, Finegold S M
Medicine (Baltimore). 1980 May;59(3):188-205.
Sixty-five cases of nosocomially acquired Legionnaires' disease are reported and the world literature is reviewed. The etiologic agent, Legionnella pneumophila, has been isolated from several environmental sources at outbreak sites. Legionnaires' disease appears to be acquired by inhalation and is primarily manifested by severe, potentially fatal, pneumonia. Characteristic clinical disease consists of high fever with relative bradycardia, dry cough, chills, diarrhea, and pleuritic pain. Although no single feature is pathognomonic, the clinical presentation is usually sufficiently characteristic to suggest the diagnosis. The diagnosis of Legionnaires' disease during acute illness may be established by culture of Legionella pneumophila, or by demonstration of the bacterium using special stains. However, in most instances, the physician must make a presumptive diagnosis based on the clinical presentation in order to institute appropriate antimicrobial therapy. Retrospective confirmation of the diagnosis may be made by serologic studies in most instances. Erythromycin is, at this time, the drug of choice for the treatment of Legionnaires' disease. A prompt salutory response following institution of erythromycin therapy is typical.
报告了65例医院获得性军团病病例，并对世界文献进行了综述。病原体嗜肺军团菌已从暴发地点的多个环境来源中分离出来。军团病似乎是通过吸入获得的，主要表现为严重的、可能致命的肺炎。典型的临床疾病包括高热伴相对心动过缓、干咳、寒战、腹泻和胸膜炎性疼痛。虽然没有单一特征具有诊断特异性，但临床表现通常具有足够的特征性以提示诊断。急性疾病期间军团病的诊断可通过嗜肺军团菌培养或使用特殊染色显示该细菌来确立。然而，在大多数情况下，医生必须根据临床表现做出推定诊断，以便开始适当的抗菌治疗。在大多数情况下，诊断可通过血清学研究进行回顾性确认。此时，红霉素是治疗军团病的首选药物。开始红霉素治疗后迅速出现有益反应是典型的。
