Legionella pneumonia due to non-Legionella pneumophila serogroup 1: usefulness of the six-point scoring system
Abstract Background Because of a limited number of reports, we aimed to investigate the clinical characteristics of patients with Legionella pneumonia due to non-Legionella pneumophila serogroup 1 and the diagnostic usefulness of the six-point scoring system for such patients compared with patients...
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doaj-3fb83586546640e19ad85dcf3bddb68f2020-11-25T00:46:08ZengBMCBMC Pulmonary Medicine1471-24662017-12-011711910.1186/s12890-017-0559-3Legionella pneumonia due to non-Legionella pneumophila serogroup 1: usefulness of the six-point scoring systemAkihiro Ito0Tadashi Ishida1Yasuyoshi Washio2Akio Yamazaki3Hiromasa Tachibana4Department of Respiratory Medicine, Ohara Healthcare Foundation, Kurashiki Central HospitalDepartment of Respiratory Medicine, Ohara Healthcare Foundation, Kurashiki Central HospitalDepartment of Respiratory Medicine, Ohara Healthcare Foundation, Kurashiki Central HospitalDepartment of Respiratory Medicine, Ohara Healthcare Foundation, Kurashiki Central HospitalDepartment of Respiratory Medicine, Ohara Healthcare Foundation, Kurashiki Central HospitalAbstract Background Because of a limited number of reports, we aimed to investigate the clinical characteristics of patients with Legionella pneumonia due to non-Legionella pneumophila serogroup 1 and the diagnostic usefulness of the six-point scoring system for such patients compared with patients with pneumonia caused by L. pneumophila serogroup 1. Methods We retrospectively analysed patients diagnosed with Legionella pneumonia due to non-L. pneumophila serogroup 1 between March 2001 and June 2016. We examined the clinical characteristics, including symptoms, laboratory findings, radiologic findings, pneumonia severity, initial treatment and prognosis. We also calculated scores using the six-point scoring system in these patients. Furthermore, we compared the clinical characteristics and six-point scores between non-L. pneumophila serogroup 1 patients and L. pneumophila serogroup 1 patients among hospitalized community-acquired pneumonia patients enrolled prospectively between October 2010 and July 2016. Results Eleven patients had pneumonia due to non-L. pneumophila serogroup 1; their median age was 66 years and 8 patients (72.7%) were male. The most common pathogen was L. pneumophila serogroup 3 (6/11), followed by L. pneumophila serogroup 9 (3/11), L. pneumophila serogroup 6 (1/11) and L. longbeachae (1/11). Non-specific symptoms, such as fever and cough, were common. Six patients (54.5%) had liver enzyme elevation, but no patient developed hyponatraemia at <130 mEq/L. Nine patients (81.8%) showed lobar pneumonia and 7 patients (63.6%) manifested with consolidation and ground-glass opacity. Patients with mild to moderate severity comprised 10 (90.9%) by CURB-65 and 5 (45.5%) by the Pneumonia Severity Index. Of all patients, 4 were admitted to the intensive care unit and 3 died despite appropriate empiric therapy. The clinical characteristics were not significantly different between non-L. pneumophila serogroup 1 patients and L. pneumophila serogroup 1 patients (n = 23). At a cut-off value of ≥ 2 points, the sensitivity of the six-point scoring system was 54.5% (6/11) for non-L. pneumophila serogroup 1 patients and 95.7% (22/23) for L. pneumophila serogroup 1 patients. Conclusions Cases of non-L. pneumophila serogroup 1 pneumonia varied in severity from mild to severe and the clinical characteristics were often non-specific. The six-point scoring system was not useful in predicting such Legionella pneumonia cases.http://link.springer.com/article/10.1186/s12890-017-0559-3Legionella pneumoniaLegionella pneumophila serogroup 1Community-acquired pneumoniaDiagnostic scoring system |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Akihiro Ito Tadashi Ishida Yasuyoshi Washio Akio Yamazaki Hiromasa Tachibana |
spellingShingle |
Akihiro Ito Tadashi Ishida Yasuyoshi Washio Akio Yamazaki Hiromasa Tachibana Legionella pneumonia due to non-Legionella pneumophila serogroup 1: usefulness of the six-point scoring system BMC Pulmonary Medicine Legionella pneumonia Legionella pneumophila serogroup 1 Community-acquired pneumonia Diagnostic scoring system |
author_facet |
Akihiro Ito Tadashi Ishida Yasuyoshi Washio Akio Yamazaki Hiromasa Tachibana |
author_sort |
Akihiro Ito |
title |
Legionella pneumonia due to non-Legionella pneumophila serogroup 1: usefulness of the six-point scoring system |
title_short |
Legionella pneumonia due to non-Legionella pneumophila serogroup 1: usefulness of the six-point scoring system |
title_full |
Legionella pneumonia due to non-Legionella pneumophila serogroup 1: usefulness of the six-point scoring system |
title_fullStr |
Legionella pneumonia due to non-Legionella pneumophila serogroup 1: usefulness of the six-point scoring system |
title_full_unstemmed |
Legionella pneumonia due to non-Legionella pneumophila serogroup 1: usefulness of the six-point scoring system |
title_sort |
legionella pneumonia due to non-legionella pneumophila serogroup 1: usefulness of the six-point scoring system |
publisher |
BMC |
series |
BMC Pulmonary Medicine |
issn |
1471-2466 |
publishDate |
2017-12-01 |
description |
Abstract Background Because of a limited number of reports, we aimed to investigate the clinical characteristics of patients with Legionella pneumonia due to non-Legionella pneumophila serogroup 1 and the diagnostic usefulness of the six-point scoring system for such patients compared with patients with pneumonia caused by L. pneumophila serogroup 1. Methods We retrospectively analysed patients diagnosed with Legionella pneumonia due to non-L. pneumophila serogroup 1 between March 2001 and June 2016. We examined the clinical characteristics, including symptoms, laboratory findings, radiologic findings, pneumonia severity, initial treatment and prognosis. We also calculated scores using the six-point scoring system in these patients. Furthermore, we compared the clinical characteristics and six-point scores between non-L. pneumophila serogroup 1 patients and L. pneumophila serogroup 1 patients among hospitalized community-acquired pneumonia patients enrolled prospectively between October 2010 and July 2016. Results Eleven patients had pneumonia due to non-L. pneumophila serogroup 1; their median age was 66 years and 8 patients (72.7%) were male. The most common pathogen was L. pneumophila serogroup 3 (6/11), followed by L. pneumophila serogroup 9 (3/11), L. pneumophila serogroup 6 (1/11) and L. longbeachae (1/11). Non-specific symptoms, such as fever and cough, were common. Six patients (54.5%) had liver enzyme elevation, but no patient developed hyponatraemia at <130 mEq/L. Nine patients (81.8%) showed lobar pneumonia and 7 patients (63.6%) manifested with consolidation and ground-glass opacity. Patients with mild to moderate severity comprised 10 (90.9%) by CURB-65 and 5 (45.5%) by the Pneumonia Severity Index. Of all patients, 4 were admitted to the intensive care unit and 3 died despite appropriate empiric therapy. The clinical characteristics were not significantly different between non-L. pneumophila serogroup 1 patients and L. pneumophila serogroup 1 patients (n = 23). At a cut-off value of ≥ 2 points, the sensitivity of the six-point scoring system was 54.5% (6/11) for non-L. pneumophila serogroup 1 patients and 95.7% (22/23) for L. pneumophila serogroup 1 patients. Conclusions Cases of non-L. pneumophila serogroup 1 pneumonia varied in severity from mild to severe and the clinical characteristics were often non-specific. The six-point scoring system was not useful in predicting such Legionella pneumonia cases. |
topic |
Legionella pneumonia Legionella pneumophila serogroup 1 Community-acquired pneumonia Diagnostic scoring system |
url |
http://link.springer.com/article/10.1186/s12890-017-0559-3 |
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