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[Clinical manifestations of Legionella pneumonia in hematology patients].
[legionellosis]
To
detect
the
most
common
clinical
manifestations
of
Legionella
pneumonia
(
LP
)
in
immunocompromized
patients
.
Clinical
manifestations
,
the
results
of
investigation
of
bronchoalveolar
lavage
fluid
(
BALF
)
and
urine
,
and
the
data
of
lung
computed
tomography
(
CT
)
were
studied
in
patients
with
blood
system
diseases
and
acute
respiratory
failure
(
ARF
)
.
The
diagnosis
of
LP
was
verified
in
8
(
10
.
5
%
)
of
76
patients
with
blood
system
diseases
and
ARF
.
The
disease
manifested
as
fever
,
higher
concentrations
of
inflammatory
markers
(
procalcitonin
,
fibrinogen
)
,
ARF
,
hypoxemia
,
and
infiltrative
lung
injury
.
Six
of
the
8
patients
were
switched
to
mechanical
ventilation
.
Lung
CT
showed
no
pathognomonic
signs
.
Five
of
the
8
patients
were
observed
to
have
renal
dysfunction
.
The
diagnosis
of
LP
was
made
on
the
basis
of
the
results
of
BALF
examination
in
7
patients
and
urinary
antigen
detection
in
1
.
The
disease
was
caused
by
Legionella
pneumophila
serogroup
1
in
3
patients
and
by
L
.
pneumophila
of
other
serogroups
in
the
other
patients
.
Therapy
with
respiratory
fluoroquinolones
was
performed
in
5
patients
.
Three
patients
died
from
progressive
ARF
and
hypoxemia
.
BALF
results
were
obtained
after
their
death
and
therapy
for
legionellosis
was
not
initiated
.
The
incidence
of
LP
is
10
.
5
%
in
hematology
patients
.
The
clinical
manifestations
of
legionellosis
are
nonspecific
;
its
diagnosis
requires
bacteriological
and
/
or
serological
evidence
.
Due
to
the
high
risk
of
death
,
it
is
reasonable
to
preuse
respiratory
fluoroquinolones
or
macrolides
in
immunocompromized
patients
with
progressive
ARF
and
suspected
Legionella
pneumonia
before
diagnosis
.
Diseases
Validation
Diseases presenting
"macrolides in immunocompromized patients with progressive arf and suspected legionella pneumonia before diagnosis"
symptom
legionellosis
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