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Átta tilfelli af Legionellosis staðfest með ræktun

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Authors
María Sigurjónsdóttir
Sigfús Karlsson
Steinn Jónsson
Sigurður B. Þorsteinsson
Ólafur Steingrímsson
Issue Date
1989-05-15

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Læknablaðið 1989, 75(5):157-65
Abstract
From January 1985 to the end of June 1988, eight cases of Legionellosis were diagnosed by culture in Iceland. The bacteria found were in all cases Legionella pneumophila serogroup 1. The bacteria were cultured from 12 samples, six bronchial washing, three sputum specimens and three transtracheal specimens. There were four women and four men, aged 37¬83 years. Five cases were considered nosocomial infection. Four had chronic lung disease and one had lung cancer. Four had been operated on under endotracheal anesthesia during the incubations period. Among the four patients who died pneumonia was considered an important factor. In the three with community-acquired infection, one had systemic lupus erythematosus and was treated with prednisolon, one had chronic lung disease and died of the pneumonia and one didn't have any known underlying disease. In all patients, antibodies to Legionella were sought, at least once, by microagglutination test. Four had elevated antibody titers to L. pneumophila serogroup 1. It is important to remember Legionellosis as a possible cause for pneumonia in people having chronic lung diseases, especially if they have undergone surgery with endotracheal anesthesia. It is also important to remember that disease in patients treated with immunosuppressive drugs.
Frá ársbyrjun 1985 til júníloka 1988 greindist legionellosis með ræktun hjá átta sjúklingum á Íslandi. Í öllum tilvikum var um að ræða Legionella pneumophila sermiflokk 1. Bakteríurnar ræktuðust úr tólf sýnum, sex berkjuskolum, þremur barkaástungusýnum og þremur hrákasýnum. Sjúklingarnir voru fjórar konur og fjórir karlar á aldrinum 37-83 ára. Fimm sýktust á sjúkrahúsi og höfðu fjórir langvinna lungnasjúkdóma og einn krabbamein í lunga. Fjórir fóru í skurðaðgerö í svæfingu og lágu á gjörgæsludeild á líklegum sýkingartíma. Af þeim fimm sem sýktust á sjúkrahúsi dóu fjórir og var lungnabólgan talin meöverkandi þáttur í dauða þeirra. Einn þriggja sem sýktust utan sjúkrahúss hafði bandvefssjúkdóm og var á sterameðferð. Annar hafði sjúkdóm í millivef lungna og dó hann af völdum lungnabólgunnar. Ekki er vitað um undirliggjandi sjúkdóma hjá þeim þriðja. Hjá öllum sjúklingunum voru athuguö mótefni gegn Legionella meö örkekkjun. Reyndust fjórir hafa mótefnahækkun gegn L. pneumophila af sermiflokki 1. Mikilvægt er aö hafa legionellosis í huga sem orsök lungnabólgu í fólki meö langvinna lungnasjúkdóma, einkum ef það hefur verið svæft vegna skurðaðgerðar. Einnig þar að vera á verði gegn sjúkdómnum ef um er að ræða lungnabólgu í kjölfar ónæmisbælandi meðferðar.
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