The Tokai journal of experimental and clinical medicine · 2016
Clinical Characteristics of Legionella Pneumonia Diagnosed with Legionella Urinary Antigen Test.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Ueda Akihiro, Oki Masayuki, Yanagi Hidetaka, Ozawa Hideki, Takagi Atsushi
Аннотация
OBJECTIVE: The aim of our study was to describe the clinical characteristics of Legionella pneumonia diagnosed with a positive urinary antigen test, and factors associated with severe Legionella pneumonia were investigated.
METHODS: We retrospectively investigated the clinical characteristics of patients with Legionella pneumonia diagnosed at Tokai University Hospital between February 2006 and June 2012. The clinical characteristics of ICU cases and non-ICU cases were compared.
RESULTS: Twenty-six patients with Legionella pneumonia were identified (mean age 66.7 ± 19.3). Twenty patients were men (76.9 %). Impaired consciousness was observed in 12 patients (46.2 %), followed by gastrointestinal symptoms (38.5 %). Ten patients had severe pneumonia which required ICU admission. A case-controlled study comparing non-ICU cases and ICU cases demonstrated that cases with diabetes (OR 10.1, 95 % CI 1.1-90.5) and tachycardia (OR 10.1, 95 % CI 1.1-90.5) were significantly associated with ICU admission.
CONCLUSIONS: Legionella pneumonia did not always present as severe pneumonia. Extrapulmonary manifestations may be useful clues for diagnosis. Diabetic patients have not only a risk of contracting Legionella pneumonia, but also a risk of progression. Legionella pneumonia should be included in the differential diagnosis even in cases of mild to moderate pneumonia when presenting with extrapulmonary symptoms, especially in diabetic patients.
METHODS: We retrospectively investigated the clinical characteristics of patients with Legionella pneumonia diagnosed at Tokai University Hospital between February 2006 and June 2012. The clinical characteristics of ICU cases and non-ICU cases were compared.
RESULTS: Twenty-six patients with Legionella pneumonia were identified (mean age 66.7 ± 19.3). Twenty patients were men (76.9 %). Impaired consciousness was observed in 12 patients (46.2 %), followed by gastrointestinal symptoms (38.5 %). Ten patients had severe pneumonia which required ICU admission. A case-controlled study comparing non-ICU cases and ICU cases demonstrated that cases with diabetes (OR 10.1, 95 % CI 1.1-90.5) and tachycardia (OR 10.1, 95 % CI 1.1-90.5) were significantly associated with ICU admission.
CONCLUSIONS: Legionella pneumonia did not always present as severe pneumonia. Extrapulmonary manifestations may be useful clues for diagnosis. Diabetic patients have not only a risk of contracting Legionella pneumonia, but also a risk of progression. Legionella pneumonia should be included in the differential diagnosis even in cases of mild to moderate pneumonia when presenting with extrapulmonary symptoms, especially in diabetic patients.