title: [Severe complications and their outcomes in 65 patients with Legionella pneumonia].
abstract: The aim of the current study was to investigate the lethal complications of Legionella pneumonia. Severe complications and their outcomes in 65 patients with Legionella pneumonia were studied. All patients who eventually had a fatal outcome or who had severe complications received antimicrobial agents active against Legionella on the admission day. Many patients in the severe complication category had multiple severe complications. Six deaths occurred (mortality rate 9.2%), 4 of which were due to septic shock/multiple organ dysfunction syndrome (MODS) (2 patients) or interstitial pneumonia/pulmonary fibrosis after Legionella pneumonia (2 patients), whereas the other 2 deaths were due to causes unrelated to Legionella pneumonia. Mortality rates for each severe complication were as follows: acute respiratory distress syndrome 27.3% (3 of 11); renal failure 33.3% (2 of 6); disseminated intravascular coagulation 33.3% (2 of 6); severe sepsis 0% (0 of 1); septic shock/MODS 66.7% (2 of 3); interstitial pneumonia/pulmonary fibrosis 50% (2 of 4). Despite prompt diagnosis and appropriate treatment with antimicrobial agents active against Legionella, the lethal complications of Legionella pneumonia are septic shock/MODS and interstitial pneumonia/pulmonary fibrosis.
authors.affiliation: Department of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center.
authors.forename: Noboru
authors.initials: N
authors.lastname: Takayanagi
authors.forename: Takashi
authors.initials: T
authors.lastname: Ishiguro
authors.forename: Aya
authors.initials: A
authors.lastname: Matsushita
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Yoshii
authors.forename: Naho
authors.initials: N
authors.lastname: Kagiyama
authors.forename: Yousuke
authors.initials: Y
authors.lastname: Miyahara
authors.forename: Koichiro
authors.initials: K
authors.lastname: Yoneda
authors.forename: Daidou
authors.initials: D
authors.lastname: Tokunaga
authors.forename: Fumiaki
authors.initials: F
authors.lastname: Aoki
authors.forename: Hiroo
authors.initials: H
authors.lastname: Saito
authors.forename: Mikio
authors.initials: M
authors.lastname: Ubukata
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Kurashima
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Yanagisawa
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Sugita
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007877:Legionnaires' Disease / Q000150:complications*; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000209:etiology; D011658:Pulmonary Fibrosis / Q000209:etiology; D012128:Respiratory Distress Syndrome / Q000209:etiology; D012772:Shock, Septic / Q000209:etiology