[Clinical and diagnostic characteristics of Legionella pneumonia].
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.
Yamaguchi
K
K
Department of Microbiology, Toho University School of Medicine.
Tateda
K
K
Ishii
Y
Y
Murakami
H
H
Matsumoto
T
T
Furuya
N
N
Kashitani
F
F
Uchida
K
K
Ubukata
M
M
Kimura
K
K
Tanaka
E
E
Tsuchida
H
H
Nishi
K
K
Hashizume
Y
Y
Homma
S
S
Hirakata
Y
Y
Yamamoto
H
H
Watari
M
M
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
D000942:Antigens, Bacterial