PDF(Pubmed)
Abstract：
Legionella pneumonia caused by Legionella pneumophila is a multi-system disease that is a life-threatening, acute, and severe form of pneumonia. L. pneumophila is widespread and the clinical manifestations of Legionella pneumonia are similar to those of typical and atypical pneumonia. Current diagnostic scores and radiologic evidence have limited diagnostic value. Thus, it is likely that many cases of Legionella pneumonia remain unreported. We describe a woman with a medical history of acute myeloid leukemia who suffered from repeated fever, and no relief following initial empirical antibiotic treatment. Ultimately, she was diagnosed with Legionella pneumonia based on metagenomic next-generation sequencing (mNGS). We also performed a systematic review of the literature and identified 5 other patients who were diagnosed with Legionella pneumonia using mNGS, and reviewed their clinical characteristics, biological characteristics, epidemiological features, laboratory results, clinical findings, and treatments. This literature review showed that accurate etiological diagnosis is becoming increasingly essential for a definitive diagnosis and treatment strategies. The clinical manifestations of Legionella pneumonia are non-specific, and many routine laboratory diagnostic tests cannot identify Legionella. mNGS, an indispensable approach for identifying microorganisms, can provide a promising tool for the rapid and accurate etiological diagnosis methods contributing to early diagnosis, early treatment, and improved prognosis, especially for uncommon species such as L. pneumophila.
摘要：
由嗜肺军团菌引起的军团菌肺炎是一种威胁生命的多系统疾病，急性,和严重的肺炎。肺炎支原体广泛分布，军团菌肺炎的临床表现与典型和非典型肺炎相似。当前的诊断评分和放射学证据具有有限的诊断价值。因此，军团菌肺炎的许多病例可能仍未报告.我们描述了一名有急性髓细胞性白血病病史的女性，她反复发烧，最初的经验性抗生素治疗后没有缓解。最终,根据宏基因组下一代测序(mNGS),她被诊断为军团菌肺炎.我们还对文献进行了系统回顾，并确定了其他5例使用mNGS诊断为军团菌肺炎的患者，并回顾了他们的临床特征，生物学特性，流行病学特征，实验室结果,临床发现，和治疗。该文献综述表明，准确的病因诊断对于确定的诊断和治疗策略变得越来越重要。军团菌肺炎的临床表现是非特异性的,和许多常规实验室诊断测试不能识别军团菌。mNGS,识别微生物不可或缺的方法，可以为有助于早期诊断的快速准确的病因诊断方法提供有希望的工具，早期治疗,和改善预后，特别是对于罕见的物种，如嗜肺乳杆菌。
