title: Clinical characteristics of 8 sporadic cases of community-acquired Legionella pneumonia in advanced age.
abstract: Legionella spp are well recognized as one of the etiologic factor in pneumonia, but it is difficult to distinguish the clinical features of Legionella infection from pneumonia due to other causes. The objective of the present study was to examine the clinical characteristics of community-acquired Legionella pneumonia in elderly patients. We reviewed the clinical, laboratory and radiographic findings in 8 patients diagnosed as having pneumonia caused by Legionella. The diagnosis was confirmed by the presence of urinary antigen, bacterial culture, polymerase chain reaction (PCR) and serum antibody. There were 6 men and 2 women, whose ages ranged from 76 to 85 years. All patients had fever and hypoxia, four patients had respiratory symptoms. The initial chest X-ray findings were varied--consolidation, ground glass opacity, pleural effusion and linear shadow. Urinary antigen was positive in 4 patients, bacterial culture in 2, PCR on the sputum in 3 and serum antibody in 2 patients. As pneumonia caused by Legionella often becomes life-threatening, especially in elderly people, it is imperative to diagnose it at the initial stage. In this study, urinary antigen proved to be the most useful diagnostic means. However, it is important to confirm the diagnosis through plural examinations.
authors: Department of General Medicine, Juntendo University School of Medicine, Tokyo. es66@med.juntendo.ac.jp
authors: Eiichiro
authors: E
authors: Sugihara
authors: Takashi
authors: T
authors: Dambara
authors: Miyoji
authors: M
authors: Aiba
authors: Masaki
authors: M
authors: Okamoto
authors: Junko
authors: J
authors: Yonemitsu
authors: Satoshi
authors: S
authors: Sonobe
authors: Hideyuki
authors: H
authors: Koga
authors: Akihiro
authors: A
authors: Inui
authors: Naoko
authors: N
authors: Hada
authors: Naomi
authors: N
authors: Matsumoto
authors: Yoko
authors: Y
authors: Goto
authors: Toshio
authors: T
authors: Naito
authors: Hiroshi
authors: H
authors: Isonuma
authors: Yasuo
authors: Y
authors: Hayashida
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017714:Community-Acquired Infections / Q000175:diagnosis* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D016952:Legionella pneumophila; D007877:Legionnaires' Disease / Q000175:diagnosis* / Q000503:physiopathology*; D008297:Male; D018410:Pneumonia, Bacterial / Q000175:diagnosis / Q000503:physiopathology; D012189:Retrospective Studies