PDF(Pubmed)
Abstract：
Legionellosis among welders and other metalworkers is a rare but potentially underappreciated occupational hazard. The same mechanisms that predispose welders to severe pneumonia from Streptococcus pneumoniae and Bacillus cereus may similarly predispose them to Legionella pneumophila infection. We present a case of a previously healthy, immunocompetent 31-year-old male welder presenting with three days of shortness of breath, hypoxia, high-grade fever, and blood-tinged sputum. Chest computed tomography (CT) revealed a lobar consolidation of the right middle and lower lobes. Laboratory evaluation showed borderline hyponatremia, hypophosphatemia, and elevated liver enzymes. The patient was ultimately intubated and started on broad-spectrum antibiotics. Multiple respiratory cultures were negative and Legionella urine antigen testing was also negative. Eventually, bronchial Legionella culture was positive for Legionella pneumophila, and a blood next-generation sequencing test also confirmed the diagnosis. He was extubated six days following admission and subsequently discharged.
摘要：
焊工和其他金属工人中的军团菌病是一种罕见但可能被低估的职业危害。使焊工易患肺炎链球菌和蜡样芽孢杆菌的重症肺炎的相同机制也可能使他们易患肺炎军团菌感染。我们提出了一个以前健康的案例，有免疫能力的31岁男性焊工表现出三天的呼吸急促，缺氧,高烧,还有带血的痰.胸部计算机断层扫描（CT）显示右中下叶的大叶巩固。实验室评估显示临界低钠血症，低磷酸盐血症,和肝酶升高。患者最终插管并开始使用广谱抗生素。多个呼吸道培养均为阴性，军团菌尿抗原检测也为阴性。最终,支气管军团菌培养为嗜肺军团菌阳性，血液下一代测序测试也证实了这一诊断。他在入院后六天被拔管，随后出院。
