title: [Clinical and diagnostic characteristics of Legionella pneumonia].
abstract: We have characterized clinical and diagnostic features in 18 cases of Legionella pneumonia. Age average of patients was 62.0 years old (male:female = 14:4) and underlying diseases were observed in 12 patients. Legionella pneumonia were diagnosed in 3, 5, 8 and 9 cases by culture, serum antibody measurement, urinary antigen detection and PCR, respectively. Sixteen cases were caused by L. pneumophila, while the other 2 cases were L. bozemanii pneumonia and L. pneumophila or L. dumoffii pneumonia. Chest X-rays of those patients showed multiple pneumonia shadows in 14 cases, alveolar shadows in 10 cases, pleural effusion in 5 cases. Blood-gas analysis on admission indicated hypoxemia in all cases with abnormal A-a DO2. Laboratory findings showed abnormal data in WBC, CRP, LDH, CPK and liver function tests (ex. GOT, GPT) in most cases. Serum antibody testing showed positive by 5 weeks after onset of pneumonia, but 10 cases of Legionella pneumonia diagnosed by other techniques were judged to be negative. In urinary antigen detection test, 6 and 2 cases showed positive 1 and 4 weeks after onset of pneumonia, respectively. Macrolide antibiotics were administered in all cases during the episode, but delay of macrolide administration was observed in 3 of 4 cases of dead outcome. Serum antibody measurement, urinary antigen detection and PCR, in addition to culture to bacteria, may be required for exact diagnosis of Legionella infection.
authors.affiliation: Department of Microbiology, Toho University School of Medicine.
authors.forename: K
authors.initials: K
authors.lastname: Yamaguchi
authors.forename: K
authors.initials: K
authors.lastname: Tateda
authors.forename: Y
authors.initials: Y
authors.lastname: Ishii
authors.forename: H
authors.initials: H
authors.lastname: Murakami
authors.forename: T
authors.initials: T
authors.lastname: Matsumoto
authors.forename: N
authors.initials: N
authors.lastname: Furuya
authors.forename: F
authors.initials: F
authors.lastname: Kashitani
authors.forename: K
authors.initials: K
authors.lastname: Uchida
authors.forename: M
authors.initials: M
authors.lastname: Ubukata
authors.forename: K
authors.initials: K
authors.lastname: Kimura
authors.forename: E
authors.initials: E
authors.lastname: Tanaka
authors.forename: H
authors.initials: H
authors.lastname: Tsuchida
authors.forename: K
authors.initials: K
authors.lastname: Nishi
authors.forename: Y
authors.initials: Y
authors.lastname: Hashizume
authors.forename: S
authors.initials: S
authors.lastname: Homma
authors.forename: Y
authors.initials: Y
authors.lastname: Hirakata
authors.forename: H
authors.initials: H
authors.lastname: Yamamoto
authors.forename: M
authors.initials: M
authors.lastname: Watari
mesh_terms: D000328:Adult; D000368:Aged; D000942:Antigens, Bacterial / Q000652:urine; D001992:Bronchoalveolar Lavage Fluid / Q000166:cytology; D005260:Female; D006801:Humans; D007876:Legionellosis / Q000175:diagnosis / Q000382:microbiology; D007877:Legionnaires' Disease / Q000175:diagnosis* / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D013902:Radiography, Thoracic
chemical_list: D000942:Antigens, Bacterial