Author/Editor     Koren, I
Title     Legionarska bolezen s hudim potekom pri astmatiku
Translated title     Legionnaires' disease with severe clinical course in asthmatic patient
Type     članek
Source     Zdrav Vestn
Vol. and No.     Letnik 64, št. 6
Publication year     1995
Volume     str. 325-8
Language     slo
Abstract     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.
Summary     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.
Descriptors     LEGIONNAIRES' DISEASE
ASTHMA
ERYTHROMYCIN