Avtor/Urednik		Koren, I
Naslov		Legionarska bolezen s hudim potekom pri astmatiku
Prevedeni naslov		Legionnaires' disease with severe clinical course in asthmatic patient
Tip		članek
Vir		Zdrav Vestn
Vol. in št.		Letnik 64, št. 6
Leto izdaje		1995
Obseg		str. 325-8
Jezik		slo
Abstrakt		Background. Legionnaires' disease is a pneumonic illness caused by gram-negative Legionella pneumophila bacilli. They cause 1 percent community-acquired pneumonias in adults. Most of the patients without immunosuppression recover without therapy or sequelae. Patients with a serious underlaying disease and/or those treated with corticosteroids have a significantly more severe clinical course. 40-80 percent may die of progressive pulmonary failure. Methods. A case report of a young patient with allergic bronchial asthma and severe clinical course of Legionnaires' disease is given. Because of airway obstruction, she was also treated with corticosteroids. Conclusions. The findings suggest the hypothesis that asthmatics with symptoms of lower respiratory tract infection who need corticosteroids due to airway obstruction, should be also treated with erythromycin, which is the drug of choice for Legionella infection. Further randomised and prospective trials should be done to confirm this hypothesis.
Izvleček		Izhodišča. Legionarsko bolezen povzroča gram negativni bacil Legionella pneumophila. Povzroča do 1 odst. pljučnic odraslih, dobljenih v domačem okolju. Večina imunsko zdravih bolnikov ozdravi spontano po enem tednu. Imunsko oslabeli bolniki in/ali tisti, ki so zdravljeni s kortikosteroidi, imajo značilno hujši potek bolezni. 4080 odst. jih umre v respiratorni odpovedi. Metode. V prispevku smo opisali primer mlajše bolnice z alergično obliko bronhialne astme, ki je zbolela s hudim potekom legionarske bolezni. Zaradi pljučne obstrukcije smo bolnico zdravili po doktrini tudi s kortikosteroidi. Zaključki. Prikazani primer dopušča hipotezo, da je astmatike, ki zbolijo z okužbo spodnjih dihalnih poti in zaradi poslabšanja osnovne bolezni potrebujejo terapijo s kortikosteroidi, treba zdraviti z eritromicinom kot najučinkovitejšim zdravilom proti Legionelli pneumophili. Nadaljnje prospektivne in randomizirane raziskave bi morale to hipotezo potrditi.
Deskriptorji		LEGIONNAIRES' DISEASE ASTHMA ERYTHROMYCIN