PDF(Pubmed)
Abstract：
Infection with Legionella spp. (legionellosis) causes two distinct clinical presentations: Legionnaires\' Disease and Pontiac Fever. Legionnaire\'s Disease primarily involves the lungs, often with accompanying gastrointestinal symptoms, and can also affect the liver, central nervous system, and kidneys, and cause metabolic derangements. Manifestations in the integumentary system are rare; to date, there have been eleven cases reported in the literature of Legionellosis with associated rash, with varied presentation. The relationship between Legionella pneumophila and the skin has not yet been clearly defined; immunological and/or toxic pathogenesis are possible. We report a case of Legionnaires\' Disease in a young immunocompromised man with a largely benign clinical course consisting of predominantly gastrointestinal symptoms and an extensive maculopapular rash. Chest radiography showed lobar infiltrate in the absence of clinical symptoms of pneumonia. The importance of this case is for clinicians to maintain high clinical suspicion for Legionella when extra-pulmonary symptoms predominate, specifically in immunocompromised hosts who may have atypical presentations and have higher mortality rates when treatment is delayed.
摘要：
军团菌感染。（军团菌病）引起两种不同的临床表现：军团病和庞蒂亚克热。军团病主要累及肺部,经常伴有胃肠道症状，还会影响肝脏，中枢神经系统,和肾脏，导致代谢紊乱.外皮系统中的表现很少；迄今为止，文献报道了11例军团菌病伴相关皮疹，不同的介绍。嗜肺军团菌与皮肤之间的关系尚未明确定义；免疫学和/或毒性发病机制是可能的。我们报告了一名免疫功能低下的年轻男子的军团病病例，其临床过程主要是良性的，主要是胃肠道症状和广泛的斑丘疹。胸部X线检查显示，在没有肺炎临床症状的情况下，肺叶浸润。这种情况的重要性是临床医生在肺外症状占优势时保持对军团菌的高度临床怀疑，特别是在免疫功能低下的宿主中，这些宿主可能具有非典型表现，并且在延迟治疗时具有较高的死亡率。
