Chlamydophila pneumoniae Chlamydophila psittaci Mycoplasma pneumoniae Legionella pneumophila C. pneumoniae C. psittaci C. pneumoniae C. psittaci M. pneumoniae M. pneumoniae C. psittaci L. pneumophila C. psittaci Key words Chlamydophila pneumoniae Chlamydophila psittaci Mycoplasma pneumoniae Legionella pneumophila I C. pneumoniae C. psittaci M. pneumoniae L. pneumophila L. pneumophila C. pneumoniae C. psittaci M. pneumoniae
Table. Criteriaforthediagnosisofpneumonia(accordingto theu.s.fdaguidelinesissuedin998) * Patientsinwhom infiltrativeimagesareseeninachestx-ray photographandabnormalityisseeninatleastitemsofthefollowingsymptoms,findingsorhematologicaltestvalues. Cough Appearanceoraggravationofpurulentsputum Raleorfindingsuggestiveofpneumosclerosisinauscultation Dyspneaorfrequentbreathing Pyrexia(> 38 )orhypothermia(< 3 ) Peripheralwhitebloodcelcountincreased(>,/mm 3 ) orstabneutrophilcountincreased(> %) orwhiteblood celcountdecreased(<,/mm 3 ) Hypoxemia(PaO< 6Tor) tonsilitis 4 7.3% 3 3.4% %.9% 6 7.4% 7 8.% 7.% 4 9.4% 3 6.% 4.% Table. Determinationmethodandjudgmentcriteria Determinationitem C.pneumoniaeIgG(MIF) C.pneumoniaeIgM(MIF) C.psitaciIgG(MIF) C.psitaciIgM(MIF) M.pneumoniae(CF) M.pneumoniae(PA) L.pneumophila(IFA) InfluenzavirustypeA InfluenzavirustypeB Judgmentwith singleserum times 3times times 3times 64times 3times 6times Judgmentwith pairedserums L. pneumophila II Table3. Distributionofinfectiousdiseasesaccordingtogeographicarea / Pneumonia/ Pneumonia Numberof patients 4 9.6% 4 48.3% 4.% 94 37.% % % %.4%.%.% % 6 6.3% % % %.4% 9 3.8% 3.% 39 3.% 93 36.6% 7 8.6%.7% 4 3.6% 3.9% 8 Sendaidistrict 87 Nigatadistrict Okayamadistrict 4 Nagasakidistrict 39.%.% 7.%.% 8 34.% 6 4.9% 3 Total
Table4. Rateofpatientspositiveforatypicalpathogensaccordingtoclinicaldiagnosis Clinicaldiagnosis Numberof patients C.pneumoniae C.psitaci Nameofatypicalmicroorganism C.pneumoniae C.psitaci C.psitaci M.pneumoniae M.pneumoniae L.pneumophila Pneumonia tonsilitis / Pneumonia/ 6 8 4 7 3 9.%.6% 33.7% 6.% 7.4% 6.3% %.8% 3.4% 3.%.8%.%.6% 4.%.% NT NT NT Total 3 7 3.%.3% 8.%.% 8.% Table. Caseswithpairedserasamples with3samples withsamples withsample Sendaiarea Nigataarea Okayamaarea Nagasakiarea 8 87 4 4(6%) 34(39%) 7(97%) 3(84%) 34(4%) 43(49%) ( %) (%) ( %) (%) ( %) 6( 6%) Total 3 399(7%) 4(%) 9( %) C. pneumoniae C. psittaci C. pneumoniae C. psittaci M. pneumoniae M. pneumoniae C. psittaci L. pneumophila L. pneumophila C. psittaci C. pneumoniae C. pneumoniae C. pneumoniae C. psittaci M. pneumoniae C. psittaci C. psittaci C. psittaci C. psittaci β β
Table6. PatientprofilesofC.psitaci-positivecases Clinicaldiagnosis Age Sex Typeofantibiotics Dailydose Period Eficacy Severity Pet,, 4 4 3 4 4 9 33 34 39 8 68 8 33 3 67 (injection) (oral) (oral) (injection) 4mg 4mg 3mg 6mg 4mg 4mg mg 3mg 3mg 3mg 3mg 3mg 4mg 3mg 3mg 3mg 3mg 3mg,mg g mg 3mg 3mg 3mg g days 8days 7days 8days 3days 8days days 3days days 7days 3days days days day days 7days day Poor Severe Severe β III C. pneumoniae C. psittaci M. pneumoniae L. pneumophila M. pneumoniae C. pneumoniae C. psittaci C. pneumoniae M. pneumoniae C. psittaci M. pneumoniae C. pneumoniae M. pneumoniae β
β C. psittaci C. psittaci C. psittaci C. psittaci β β C. pneumoniae C. pneumoniae
Chlamydophila pneumoniae Chlamydophila psittaci Mycoplasma pneumoniaelegionella pneumophila C. pneumoniae C. psittaci M. pneumoniae L. pneumophila L. pneumophila C. psittaci