Legionella pneumonia

Cause pathogenesis of Legionnaires disease (legionaires disease) is a Gram-negative staining of Legionella pneumophilia bacilli (legionella pneumophila) caused a pneumonia mainly to the entire body disease, was confirmed in 1976. Legionella bacteria in the presence of L-cysteine ferrous salt and yeast extract active yeast extract agar (B-medium CYE ) can only grow. A type of bacteria found in water and soil, often by the water systems, air-conditioning and aerosol inhalation and be inhaled, causing respiratory infection, also showed a small outbreak. And the middle-aged and elderly people with chronic heart, lung, kidney, diabetes, blood diseases, and malignant tumors, AIDS or inhibitors were susceptible to the disease. Such opportunities to persons infected with mortality as high as 45%. Pulmonary purulent bronchitis, but also for large-leaf inflammation, accompanied by a small abscess, and Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Candida, Pneumocystis carinii and cryptococcal infection, such as hybrid and "refractory pneumonia." Slow onset of clinical performance, but also by 2 -10 days and the sharp onset latency. The disease outbreak was available. A weak, muscle pain, headache and fever chills, 20% patients can be relative bradycardia. Phlegm less viscous and blood, but was not generally purulent. May also have nausea, vomiting and watery diarrhea. Severe neurological symptoms. If you feel numb, delirium and may respiratory failure and shock. Diagnostic X-ray revealed pneumonia early as peripheral Patchy pulmonary infiltration within, and then it changed lung, lower lobe see more. Unilateral or bilateral, disease progress rapidly, but also associated with pleural effusion. Bronchial aspirates, thoracic fluid, bronchial lavage Zonghuai for L. see staining cells can be found within the Corps bacilli. These specimens by direct immunofluorescence antibody and gene probes can detect positive. PCR amplified gene fragments isolated to the rapid diagnosis. Indirect immunofluorescence antibody test, serum tube agglutination test and serum trace agglutination test, Both antibody titer was four times the growth, respectively 1 : 128,1:64 or higher, may diagnosis. In addition, urine ELISA detection of bacteria soluble antigen, also has high specificity. WBC over more than 10 × 109 / L, neutrophil cells left, sometimes with impaired renal function. Arterial blood gas analysis may suggest hypoxemia. For the treatment of first choice erythromycin, a daily 1 - 2g, in four oral and intravenous administration to severe, medication 2-3 weeks. Can be increased with rifampicin, a daily 10 mg / kg oral one; Doxycycline 200 mg daily, one oral, treatment three weeks or more, otherwise easy to relapse. Amino - glycosides and penicillin and cephalosporin antibiotics fungi of the disease invalid.