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Klinisches Bild der Legionärskrankheit

Clinical picture of legionnaires' disease

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Zusammenfassung

Die Legionellosen können klinisch als relativ harmlose Atemwegsinfektion ablaufen, jedoch treten sie häufiger als schwere atypische Pneumonie in Erscheinung. Sechs unterschiedlicheLegionella-Spezies sind bisher bekannt, von denenLegionella pneumophila am häufigsten zu sein scheint. Die Legionärspneumonie tritt vermehrt bei männlichen älteren Patienten mit Vorerkrankungen bevorzugt im Sommer oder Herbst auf; die Klinik ist charakterisiert durch virale „Prodromi“, hohes Fieber, unproduktiven Reizhusten, Thoraxschmerzen, Verwirrtheit, Diarrhöen, Hämaturie, mäßige Leukozytose mit Lymphopenie, niedrigem Serum-Natrium und negativen mikrobiologischen Analysen von Sputum und Pleuraexsudat. Die Diagnosesicherung erfolgt kulturell, mikroskopisch und serologisch, wobei zur Zeit der indirekte Immunfluoreszenztest besonders hilfreich ist. Mittel der Wahl zur Behandlung sind Erythromycin alleine oder in Kombination mit Rifampicin.

Summary

Legionella infections can take the clinical course of a relatively harmless respiratory infection. However, serious, atypical pneumonia is a more frequent manifestation of infection with these pathogens. As yet, six differentLegionella species can be identified;Legionella pneumophila appears to be the most common. Legionnaires' pneumonia is being found with increasing regularity during summer and autumn in elderly male patients with previous illnesses. The clinical picture is characterised by viral “prodrome”, high fever, a dry cough, breast pain, confusion, diarrhoea, haematuria, moderate leukocytosis with lymphopenia, low concentrations of sodium in the serum and negative results from microbiological analysis of the sputum and pleural exudate. Diagnosis is confirmed culturally, microscopically and serologically; the indirect immunofluorescence test is of particular value for this purpose. Erythromycin alone or in combination with rifampicin is the treatment of choice.

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Literatur

  1. Fraser, D. W., Tsai, T. R., Orenstein, W., Parkin, W. E., Beecham, H. J., Sharrar, R. G., Harris, J., Mallison, G. F., Martin, S. M., McDade, J. E., Shepard, C. C., Brachman, P. S. Legionnaires' disease — description of an epidemic of pneumonia. N. Engl. J. Med. 297 (1977) 1189–1197.

    Google Scholar 

  2. McDade, D. E., Shepard, C. C., Fraser, D. W., Tsai, T. R., Reches, M. A., Dowdle, W. R. Legionnaires' disease — isolation of bacterium and demonstration of its role in other respiratory diseases. N. Engl. J. Med. 297 (1977) 1197–1203.

    Google Scholar 

  3. Meyer, R. D., Edelstein, P. H., Kirby, B., Louie, M. H., Mulligan, M. E., Morgenstein, A. A., Finegold, S. M. Legionnaires' disease: Unusual clinical and laboratory features. Ann. Int. Med. 93 (1980) 240–243.

    Google Scholar 

  4. Flesher, A. R., Kasper, D. L., Modern, P. R., Mason, E. O. Legionella pneumophila: Growth inhibition by human pharyngeal flora. J. Infect. Dis. 142 (1980) 313–317.

    Google Scholar 

  5. Swartz, M. N. Clinical aspects of Legionnaires' Disease. Ann. Int. Med. 90 (1979) 492–495.

    Google Scholar 

  6. Glick, T. H., Greeg, M. B., Berman, B., Mallison, G., Rhodes, W. W., Karsanoff, J. Pontiac fever: an epidemic of unknown etiology in a health department. I. Clinical and epidemiologic aspects. Am. J. Epidemiol. 107 (1978) 149–160.

    Google Scholar 

  7. Tsai, T. F., Finn, D. R., Tlileaytis, B. D., McCauley, W., Martin, S. M., Fraser, D. W. Legionnaires' disease: Clinical features of the epidemic in Philadelphia. Ann. Int. Med. 90 (1979) 509–517.

    Google Scholar 

  8. Dietrich, P. A., Johnson, R. D., Fairbank, J. T., Walke, J. S. The chest radiograph in Legionnaires' disease. Radiology 127 (1978) 577–582.

    Google Scholar 

  9. Helms, C. M., Viner, J. P., Stuom, R. H., Renner, E. D., Johnson, W. Comparative features of pneumococcal, mycoplasmal, and Legionnaires' disease pneumonias. Ann. Int. Med. 90 (1979) 543–547.

    Google Scholar 

  10. Miller, A. C. Early clinical differentiation between Legionnaires' disease and other sporadic pneumonias. Ann. Int. Med. 90 (1979) 526–528.

    Google Scholar 

  11. Edelstein, P., Meyer, R. D. Susceptibility ofLegionella pneumophila to twenty antimicrobial agents. Antimicrob. Agents Chemother. 18 (1980) 403–408.

    Google Scholar 

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Authors and Affiliations

  1. Medizinische Klinik im Klinikum Steglitz der Freien Universität Berlin, Hindenburgdamm 30, D-1000, Berlin 45

    H. Lode,  H. Schäfer &  R. Schoeller

  2. Max von Pettenkofer-Institut für Hygiene und Medizinische Mikrobiologie der Universität München, Außenstelle Klinikum Großhadern, Marchioninistraße 15, D-8000, München 70

    R. Ruckdeschel

Authors
  1. H. Lode
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  2. H. Schäfer
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  3. R. Schoeller
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  4. R. Ruckdeschel
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Lode, H., Schäfer, H., Schoeller, R. et al. Klinisches Bild der Legionärskrankheit. Infection 10 (Suppl 2), S70–S73 (1982). https://doi.org/10.1007/BF01640858

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