Legionella pneumonia

Outlined by the Legionella pneumophila (gram-negative bacteria) caused by a lung infection, the only light influenza-like symptoms, Formation severe pneumonia, accompanied pulmonary symptoms of the disease known as Legionella bacteria. Medical acute heat sickly look, relative bradycardia, hypotension, shortness of breath, superficial lymph nodes hepatosplenomegaly, Pulmonary involvement can hear and moist rales, a small amount of pleural effusion signs. With pulmonary lesions at the corresponding signs. Auxiliary inspection (1) X-ray, the lack of specificity, early on one side or both sides of Patchy shadow late for inflammatory infiltration, lung disappearing abscess and found only empty immunosuppressed patients may have pleural effusion. (2) etiology inspection : 1, sputum, blood or pleural effusion develop Legionella bacteria can be diagnosed, 2, bacterial antigen and DNA testing, available direct fluorescent antibody (OFA). Enzyme-linked immunosorbent assay (ELISA) Radioimmunoassay (RIA). Gene probe and polymerase chain reaction (PCR). 3, the serum - specific antibody detection : an indirect fluorescent antibody (IFA), Enzyme-linked immunosorbent assay (ELISA), trace pollution test and measurement collection test tube (TAL). (3) Other inspections : leukocyte count more than normal or slightly increased, some neutrophil cells left, Leukocyte reduction poor prognosis. Have hematuria, aspartate aminotransferase and lactate increased enzyme from light, jaundice, low copper, hypomagnesemia. A clinical performance, often smoking, alcohol abuse and induced immunosuppression, and other factors. 2, the precursor symptoms of weakness, drowsiness, fever, headache and muscle-ache. 3, respiratory symptoms of cough, sputum (phlegm mucus, purulent sputum or phlegm), chest pain and breathing difficulties. 4, pulmonary symptoms : nausea, vomiting, diarrhea (loose stool or water it), lethargy, fuzzy state of unconsciousness, delirium, coma, dementia, anxiety, convulsions, disorientation, depression, hallucinations, insomnia, forgetfulness, speech impairment, the expression disorders performance. A treatment. Antibiotic therapy : erythromycin preferred mild 0.5 g 1 / 6h oral, severe 1.5 ~ 2g / d infusion. New penicillin or 0.5 vibrator times / d, for 4 days; Klacid 0.25g 1 / 12 hours After 0.2 g 1 / Day, or 0.1g 2 times / d. 7 ~ 14 treatment days, immunosuppression or serious illness, a meeting of ofloxacin 0.4 g / 12h, Ciprofloxacin 0.5 g 1 / 12 hours of oral or 0.4g 1 / 12 h infusion. Antibiotic use, low immune function should be not less than three weeks, a lung abscess should be extended to 3 ~ 4 weeks. 2. Rifampin : 3 -5 days of the initial 0.6 g, 2 times / d, or with erythromycin and sulfamethoxazole (SMZ - TMP) is used in conjunction with good effect. 3. Symptomatic treatment : give cough, Huatan drugs, hypotension, respiratory failure should be given oxygen and respiratory support, immunosuppressants original application should stop or reduce, adrenal dysfunction, hormone use when necessary. Differential diagnosis with other pathogens pneumonia caused by differential phase