[Community-acquired pneumonia due to Legionella pneumophila serogroup 1. Study of 97 cases]. / Neumonía comunitaria por Legionella pneumophila serogrupo 1. Estudio de 97 casos.
Enferm Infecc Microbiol Clin
; 21(8): 394-400, 2003 Oct.
Article
em Es
| MEDLINE
| ID: mdl-14525703
ABSTRACT
INTRODUCTION:
Legionella pneumophila is the causal agent of 5% to 12% of sporadic community-acquired pneumonia cases, though rates are changing with the use of new diagnostic methods.METHODS:
This is a retrospective study of all patients admitted to our hospital with community-acquired pneumonia due to Legionella pneumophila between 1997 and 2001. Diagnostic criteria included either a positive Legionella serogroup 1 urinary antigen test or seroconversion and a chest radiograph consistent with pneumonia.RESULTS:
A total of 97 patients were studied. Ninety cases (92.8%) were community-acquired and 7 (7.2%) were associated with travelling. In 82 cases (84.5%) the presentation was sporadic. Seventy-five patients were smokers (77.3%). The most common symptoms were fever in 91 patients (93.8%) and cough in 67 (68.1%). In five patients (5.2%) creatine phosphokinase concentrations were over 5 times their baseline values (in two over 100 times); four of these patients presented acute renal failure. Seroconversion was observed in 23/42 patients (54.8%). There were no statistically significant differences between the administration of erythromycin or clarithromycin in monotherapy, or in combination with rifampin. Nineteen patients (19.6%) presented acute renal failure and mechanical ventilation was necessary in 22 (22.7%). Twelve patients died (12.5%). Independent prognostic factors associated with death included respiratory rate > 30 breaths/min, urea > 60 mg/dL and PaO2 < 60 mmHg. A significant linear association was found between severity scale scores and the presence of complications or mortality.CONCLUSION:
The Legionella urinary antigen test permits early diagnosis and treatment of this disease. The severity scale is an indicator of complications or death.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Doença dos Legionários
/
Legionella pneumophila
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
/
Screening_studies
País/Região como assunto:
Europa
Idioma:
Es
Revista:
Enferm Infecc Microbiol Clin
Assunto da revista:
DOENCAS TRANSMISSIVEIS
/
MICROBIOLOGIA
Ano de publicação:
2003
Tipo de documento:
Article