[Legionella pneumonia--epidemiology, clinical characteristics and development of diagnosis].
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, 7 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 due to L. bozemanii and L. pneumophila or L. dumoffii. 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 of 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
D042462:4-Quinolones; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D000890:Anti-Infective Agents / Q000008:administration & dosage; D000904:Antibiotics, Antitubercular / Q000008:administration & dosage; D004917:Erythromycin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D016952:Legionella pneumophila / Q000302:isolation & purification; D007877:Legionnaires' Disease / Q000175:diagnosis / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D008911:Minocycline / Q000008:administration & dosage; D012293:Rifampin / Q000008:administration & dosage
D042462:4-Quinolones; D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D000904:Antibiotics, Antitubercular; D004917:Erythromycin; D008911:Minocycline; D012293:Rifampin