肺结核合并军团菌肺炎9例分析

Analysis of 9 cases of pulmonary tuberculosis complicated with legionnaires disease

目的探讨肺结核合并军团菌肺炎的特点，以防延误诊治。方法回顾性分析９例肺结核合并军团菌肺炎患者。结果肺结核合并军团菌肺炎在临床上不具有特征性，临床表现各异，胸部Ｘ线形态多种多样；并且军团菌与其它致病菌有交叉抗体存在，故很难与肺结核合并其它致病菌感染相鉴别。必须通过应用红霉素和利福平治疗是否见效以及治疗前后军团菌血清抗体滴度４倍以上的降低方可确诊。结论只有对该病予以重视，及早做血清军团菌抗体检查，方可提供诊断的主要依据，以减少误诊。

Objective To study the characteristics of pulmonary tuberculosis complicated with legionnaires disease (LD) to avoid misdiagnosis and incorrect treatment. Method Nine cases of pulmonary tuberculosis complicated with LD were retrospectively analyzed. Result The clinical and chest Xray manifestations varied, and no characteristics were found in these cases. Because cross antibodies existed between Legionella pneumophila and other causal bacteria, it was found difficult to differentiate LD, pulmonary tuberculosis and other causal bacteria infection. Efficacy of erythromycin combined with rifampicin, and decrease of serum titres of Legionella pneumophila four times after treatment were found helpful for definite diagnosis of LD. Conclusion Only paying much attention to LD, and detecting the serum antibody as early as possible can provide evidence for diagnosing of the disease.