Author/Editor		Lešničar, Gorazd
Title		Sporadičen primer legionarske bolezni domačega okolja s fulminantnim potekom
Translated title		A sporadic case of community acquired legionnaires' disease with a fulminant course
Type		članek
Source		Med Razgl
Vol. and No.		Letnik 38, št. Suppl 2
Publication year		1999
Volume		str. 151-9
Language		slo
Abstract		Legionnaires' disease is not rare in Slovenia. 39 cases have been reported to the Institute of Public Health of Slovenia since 1987, 4 of them were hospitalised at the Departmern for Infectious Diseases and Febrile States in the General Hospital in Celje. Three patients died, one of whom was treated in our hospital: a sporadic, community acquired disease in a previously healthy young man, who, in spite of early treatment with parenteral erythromycin had a fulminant course. On the seventh day of disease (the fourth day of hospital treatment) the patient died with the clinical picture of respiratory failure and sepsis. The reason for such a fulminant course of Legionnaires' disease remains unexplained. We presume there was an undiscovered immune deficiency or a high virulence of the causative agent. Legionnaires' disease should always be included in the differential diagnosis of atypic pneumonia and febrile diseases, primarily because the success of treatment depends on timely therapy with effective antibiotics, that is a macrolide (or quinolone, tetracycline) in combination with ritampin.
Summary		Legionarska bolezen v Sloveniji ni redka. Po letu 1987 smo epidemiološki službi prijavili 39 primerov, od katerih smo 4 bolnike, ki so izpolnjevali merila za zanesljivo diagnozo, zdravili na Oddelku za nalezljive bolezni in vročinska stanja Splošne bolnišnice v Celju. Od teh bolnikov, ki so doslej umrli, smo enega zdravili v celjski bolnišnici: sporadična bolezen domačega okolja je pri mladem, prej zdravem fantu, kljub zgodnjemu zdravljenju s parenteralnim eritromicinom potekala fulminantno. Bolnik je sedmi dan bolezni (četrti dan bolnišničnega zdravljenja) umrl s klinično sliko odpovedi dihanja in sepso. Vzrok za tako bliskovit potek legioneloze pri našem bolniku je ostal nepojasnjen. Predvidevamo, da je šlo za morebitno neodkrito imunsko pomanjkljivost ali visoko virulenco povzročitelja. Članek opozarja, da moramo v diferencialno diagnostiko atipičnih pljučnic in vročinskih obolenj vselej vključiti tudi legionarsko bolezen, saj je uspeh zdravljenja odvisen od pravočasnega zdravljenja z učinkovitimi antibiotiki, tj. makrolidom (ali kinolonom, tetraciklinom), v kombinaciji z rifampicinom.
Descriptors		LEGIONNAIRES' DISEASE ADULT FATAL OUTCOME COMMUNITY-ACQUIRED INFECTIONS LEGIONELLA PNEUMOPHILA