BACKGROUND Legionella pneumophila(L.pneumophila)is a gram-negative intracellular bacillus composed of sixteen different serogroups.It is mostly known to cause pneumonia in individuals with known risk factors as immuno...BACKGROUND Legionella pneumophila(L.pneumophila)is a gram-negative intracellular bacillus composed of sixteen different serogroups.It is mostly known to cause pneumonia in individuals with known risk factors as immunocompromised status,tobacco use,chronic organ failure or age older than 50 years.Although parapneumonic pleural effusion is frequent in legionellosis,pleural empyema is very uncommon.In this study,we report a case of fatal pleural empyema caused by L.pneumophila serogroup 1 in an 81-year-old man with multiple risk factors.CASE SUMMARY An 81-year-old man presented to the emergency with a 3 wk dyspnea,fever and left chest pain.His previous medical conditions were chronic lymphocytic leukemia,diabetes mellitus,chronic kidney failure,hypertension and hyperlipidemia,without tobacco use.Chest X-ray and comouted tomographyscan confirmed a large left pleural effusion,which puncture showed a citrine exudate with negative standard bacterial cultures.Despite intravenous cefotaxime antibiotherapy,patient’s worsening condition after 10 d led to thoracocentesis and evacuation of 2 liters of pus.The patient progressively developed severe hypoxemia and multiorgan failure occurred.The patient was treated by antibiotherapy with cefepime and amikacin and with adequate symptomatic shock treatment,but died of uncontrolled sepsis.The next day,cultures of the surgical pleural liquid samples yielded L.pneumophila serogroup 1,consistent with the diagnosis of pleural legionellosis.CONCLUSION L.pneumophila should be considered in patients with multiple risk factors and undiagnosed pleural empyema unresponsive to conventional antibiotherapy.展开更多
目的研究深圳市公共场所中央空调冷却塔水中分离的嗜肺军团菌血清Ⅰ型(LpⅠ)的基因特征。方法应用脉冲场凝胶电泳(Pulsed-Field Gel Electrophoresis,PFGE)技术对30株LpⅠ型军团菌进行电泳,并经Bionumer-ics软件进行聚类分析。结果30株...目的研究深圳市公共场所中央空调冷却塔水中分离的嗜肺军团菌血清Ⅰ型(LpⅠ)的基因特征。方法应用脉冲场凝胶电泳(Pulsed-Field Gel Electrophoresis,PFGE)技术对30株LpⅠ型军团菌进行电泳,并经Bionumer-ics软件进行聚类分析。结果30株菌可分为28种PFGE型。不同地区间分离出部分菌株,经PFGE分型,相似性系数为100%,表明深圳市公共场所中央空调冷却塔水间可能存在交叉污染;同一地区,菌株间相似性系数存在差异,没有优势菌株;同一采样地点,存在两种以上PFGE型别。结论深圳市公共场所冷却塔水中分离的LpⅠ型菌株基因呈多样性。展开更多
文摘BACKGROUND Legionella pneumophila(L.pneumophila)is a gram-negative intracellular bacillus composed of sixteen different serogroups.It is mostly known to cause pneumonia in individuals with known risk factors as immunocompromised status,tobacco use,chronic organ failure or age older than 50 years.Although parapneumonic pleural effusion is frequent in legionellosis,pleural empyema is very uncommon.In this study,we report a case of fatal pleural empyema caused by L.pneumophila serogroup 1 in an 81-year-old man with multiple risk factors.CASE SUMMARY An 81-year-old man presented to the emergency with a 3 wk dyspnea,fever and left chest pain.His previous medical conditions were chronic lymphocytic leukemia,diabetes mellitus,chronic kidney failure,hypertension and hyperlipidemia,without tobacco use.Chest X-ray and comouted tomographyscan confirmed a large left pleural effusion,which puncture showed a citrine exudate with negative standard bacterial cultures.Despite intravenous cefotaxime antibiotherapy,patient’s worsening condition after 10 d led to thoracocentesis and evacuation of 2 liters of pus.The patient progressively developed severe hypoxemia and multiorgan failure occurred.The patient was treated by antibiotherapy with cefepime and amikacin and with adequate symptomatic shock treatment,but died of uncontrolled sepsis.The next day,cultures of the surgical pleural liquid samples yielded L.pneumophila serogroup 1,consistent with the diagnosis of pleural legionellosis.CONCLUSION L.pneumophila should be considered in patients with multiple risk factors and undiagnosed pleural empyema unresponsive to conventional antibiotherapy.
文摘目的研究深圳市公共场所中央空调冷却塔水中分离的嗜肺军团菌血清Ⅰ型(LpⅠ)的基因特征。方法应用脉冲场凝胶电泳(Pulsed-Field Gel Electrophoresis,PFGE)技术对30株LpⅠ型军团菌进行电泳,并经Bionumer-ics软件进行聚类分析。结果30株菌可分为28种PFGE型。不同地区间分离出部分菌株,经PFGE分型,相似性系数为100%,表明深圳市公共场所中央空调冷却塔水间可能存在交叉污染;同一地区,菌株间相似性系数存在差异,没有优势菌株;同一采样地点,存在两种以上PFGE型别。结论深圳市公共场所冷却塔水中分离的LpⅠ型菌株基因呈多样性。
