Abstract：
BACKGROUND: Legionnaire\'s disease is a community-acquired pneumonia caused by the Gram-negative bacterium Legionella pneumophila. This disease is often associated with neurological symptoms, the clinical presentation of which can be very varied.
METHODS: We report a 47-year-old female patient who developed Legionnaires\' disease with cerebellar symptoms (ataxia, dysarthria and hypermetria). Laboratory tests revealed a biological inflammatory syndrome. The cerebrospinal fluid was sterile. Urinary antigen test and serology were positive for L. pneumophila. An interstitial syndrome of the right upper lobe was detected on chest computed tomography (CT) scan. Brain imaging (magnetic resonance imaging and CT angiography) showed no abnormalities. The outcome was favourable after treatment with spiramycin, levofloxacin and corticosteroids.
CONCLUSIONS: Few cases only (n=110) of Legionnaires\' disease with cerebellar symptoms have been reported in the literature. The pathogenic mechanism behind neurological dysfunction in patients with Legionnaires\' disease is unknown. Neurological symptoms improve with antibiotic therapy and corticosteroids. Extra-pulmonary forms of Legionnaires\' disease are frequent, with neurological symptoms being the most common symptoms. Cerebellar dysfunction may be underestimated and requires appropriate management with antibiotic therapy and corticosteroid therapy. Recommendations for the management of Legionnaire\'s disease with severe extra-pulmonary symptoms are needed.
METHODS: We report a 47-year-old female patient who developed Legionnaires\' disease with cerebellar symptoms (ataxia, dysarthria and hypermetria). Laboratory tests revealed a biological inflammatory syndrome. The cerebrospinal fluid was sterile. Urinary antigen test and serology were positive for L. pneumophila. An interstitial syndrome of the right upper lobe was detected on chest computed tomography (CT) scan. Brain imaging (magnetic resonance imaging and CT angiography) showed no abnormalities. The outcome was favourable after treatment with spiramycin, levofloxacin and corticosteroids.
CONCLUSIONS: Few cases only (n=110) of Legionnaires\' disease with cerebellar symptoms have been reported in the literature. The pathogenic mechanism behind neurological dysfunction in patients with Legionnaires\' disease is unknown. Neurological symptoms improve with antibiotic therapy and corticosteroids. Extra-pulmonary forms of Legionnaires\' disease are frequent, with neurological symptoms being the most common symptoms. Cerebellar dysfunction may be underestimated and requires appropriate management with antibiotic therapy and corticosteroid therapy. Recommendations for the management of Legionnaire\'s disease with severe extra-pulmonary symptoms are needed.
摘要：
背景：军团菌病是由嗜肺军团菌引起的社区获得性肺炎。这种疾病通常与神经症状有关，其临床表现可能非常不同。
方法：我们报告了一名47岁的女性患者，该患者发展为伴有小脑症状的军团病（共济失调，构音障碍和高度构音障碍）。实验室检查显示一种生物炎症综合征。脑脊液无菌。尿抗原检测和血清学检查均为嗜肺乳杆菌阳性。在胸部计算机断层扫描（CT）扫描中检测到右上叶的间质综合征。脑成像（磁共振成像和CT血管造影）未见异常。螺旋霉素治疗后结果良好，左氧氟沙星和皮质类固醇。
结论：只有少数病例（n=110）在文献中报道了伴有小脑症状的军团病。军团病患者神经功能障碍的致病机制尚不清楚。抗生素治疗和皮质类固醇可改善神经系统症状。肺外形式的军团病很常见，神经症状是最常见的症状。小脑功能障碍可能被低估，需要抗生素治疗和皮质类固醇治疗的适当管理。需要建议治疗具有严重肺外症状的军团病。
方法：我们报告了一名47岁的女性患者，该患者发展为伴有小脑症状的军团病（共济失调，构音障碍和高度构音障碍）。实验室检查显示一种生物炎症综合征。脑脊液无菌。尿抗原检测和血清学检查均为嗜肺乳杆菌阳性。在胸部计算机断层扫描（CT）扫描中检测到右上叶的间质综合征。脑成像（磁共振成像和CT血管造影）未见异常。螺旋霉素治疗后结果良好，左氧氟沙星和皮质类固醇。
结论：只有少数病例（n=110）在文献中报道了伴有小脑症状的军团病。军团病患者神经功能障碍的致病机制尚不清楚。抗生素治疗和皮质类固醇可改善神经系统症状。肺外形式的军团病很常见，神经症状是最常见的症状。小脑功能障碍可能被低估，需要抗生素治疗和皮质类固醇治疗的适当管理。需要建议治疗具有严重肺外症状的军团病。
