PDF(Pubmed)
Abstract：
Legionnaires\' disease is an atypical pneumonia caused by Legionella pneumophila (L. pneumophila) pneumonia that features slow onset, nonproductive cough, fatigue, headache, sore throat, myalgias, and malaise. It can be difficult to diagnose, as it presents with extrapulmonary symptoms, and delay in treatment can be fatal. Here, we present the case of a previously healthy 32-year-old Caucasian male with Legionnaires disease who only presented to the clinic with abdominal pain and diarrhea. The patient did not have any pulmonary symptoms at the initial presentation. This presentation did not fit the diagnostic tools available for Legionnaires\' disease, including a validated clinical prediction rule, which ruled out L. pneumophila infection with a sensitivity of 97% and a negative predictive value of 99.4%. Due to the complaint of abdominal pain, a flat/upright abdominal X-ray was ordered, which includes a chest X-ray. Upon analyzing the chest X-ray, a right lower lobe consolidation was identified, prompting an L. pneumophila urinary test to be added to the lab orders. This case represents the difficulties in diagnosing Legionnaires\' disease due to the diverse clinical complexities of presentations, which may solely involve abdominal complaints.
摘要：
军团菌病是由嗜肺军团菌引起的非典型肺炎（L.肺炎）肺炎，以缓慢发作为特征，非生产性咳嗽,疲劳,头痛,喉咙痛,肌痛,和不适。很难诊断,因为它表现出肺外症状，延迟治疗可能是致命的。这里,我们介绍了一例先前健康的32岁白种人男性军团病患者,他仅出现腹痛和腹泻到临床就诊.患者在初次就诊时没有任何肺部症状。本演示文稿不适合军团病的诊断工具，包括经过验证的临床预测规则，其中排除了肺炎支原体感染，敏感性为97％，阴性预测值为99.4％。由于腹痛的主诉，订购了平坦/直立的腹部X光片，包括胸部X光片.在分析胸部X光后，确定了右下叶合并，促使将嗜肺乳杆菌尿检添加到实验室订单中。这种情况下，由于表现的不同临床复杂性，在诊断军团病方面存在困难。这可能只涉及腹部不适。
