title: Retrospective study of 30 cases of Legionella pneumonia in the Kansai region.
abstract: Thirty Legionella pneumonia cases were clinically investigated retrospectively from 1999 to 2005 at the Respiratory Medicine Department of Kyoto University and affiliated hospitals. Twenty-eight cases were sporadic and two cases were part of an outbreak. The patients consisted of 28 men and 2 women, with a mean age of 58.8 years (range 25-87). Nineteen cases were smokers and 19 had some underlying disease. The mean period from the disease occurrence to presenting at a hospital was 4.8 days (range 1-15). The mean period from presenting at hospital to Legionella pneumonia diagnosis was 4.6 days (range 0-22). Urinary antigen detection tests for Legionella pneumophilla were performed for 25 cases, and resulted in the diagnosis of 22 cases. Other diagnostic tests with positive findings were culture (buffered charcoal-yeast extract agar, BCYE), the polymerase chain reaction (PCR) test, and serological diagnosis (enzyme immunoassay and microagglutination test). Legionella species diagnosis was obtained by culture and serology for 13 cases: 10 cases had Legionella pneumophila serogroup 1, 2 cases had Legionella pneumophila serogroup 6, and 1 case had Legionella longbeachea. Fluoloquinolones (Fq) are most often used for therapy, especially in recent cases, and were predominantly the chosen treatment (70%). Death due to Legionella pneumonia occurred in 4 cases: 3 cases had severe underlying diseases, and 1 case took 18 days to diagnose (doctors' delay). To detect the majority of Legionella pneumonia cases, a combination of diagnostic examinations is still needed. Regarding the management of community-acquired pneumonia, both the cost and the indication of diagnostic examinations for Legionella infection should be considered simultaneously.
authors.affiliation: Department of Respiratory Medicine, Japanese Red Cross Society, Wakayama Medical Center, 4-20 Komatsubara-dori, Wakayama, 640-8558, Japan. komaniwa@wakayama.email.ne.jp
authors.forename: Ko
authors.initials: K
authors.lastname: Maniwa
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Taguchi
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Ito
authors.forename: Michiaki
authors.initials: M
authors.lastname: Mishima
authors.forename: Shin-Ichi
authors.initials: S
authors.lastname: Yoshida
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000890:Anti-Infective Agents / Q000627:therapeutic use; D005260:Female; D024841:Fluoroquinolones / Q000627:therapeutic use; D006801:Humans; D007564:Japan / Q000453:epidemiology; D044128:Legionella longbeachae / Q000302:isolation & purification*; D016952:Legionella pneumophila / Q000302:isolation & purification*; D007876:Legionellosis / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D007877:Legionnaires' Disease / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
chemical_list: D000890:Anti-Infective Agents; D024841:Fluoroquinolones