Clinical characteristics of 8 sporadic cases of community-acquired Legionella pneumonia in advanced age.
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.
Sugihara
Eiichiro
E
Department of General Medicine, Juntendo University School of Medicine, Tokyo. es66@med.juntendo.ac.jp
Dambara
Takashi
T
Aiba
Miyoji
M
Okamoto
Masaki
M
Yonemitsu
Junko
J
Sonobe
Satoshi
S
Koga
Hideyuki
H
Inui
Akihiro
A
Hada
Naoko
N
Matsumoto
Naomi
N
Goto
Yoko
Y
Naito
Toshio
T
Isonuma
Hiroshi
H
Hayashida
Yasuo
Y
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