Key words: Legionella pneumonia, culture-positive, Japanese patients Legionella (L. pneumophila (L. micdadei, L. bozemanii,
Table 1 Profiles of 28 patients with Legionella pneumonia in Japan, 1980-1990 a) Y Taguchi, personal communication b) M. Hayase, personal communication c) A. Nakamura, personal communication d) T. Minowa, personal communication e) Y Matsuno, personal communication *Died of other unrel ated diseases or pneumonia due to other bacterial species
L. dumoffii) Table 2 Number of patients with community-acquired or nosocomial Legionella pneumonia Table 3 Underlying diseases in patients with Legionella pneumonia Table 4 Age and sex of community-acquired or nosocomial patients with Legionella pneumonia
Fig. 1 Monthly incidence of patients with Legionella pneumonia Fig. 2 Age distribution in patients with Legionella pneumonia Table 5 Occupation of community-acquired or nosocomial pneumonia patients with Legionella
Table 6 Travel history in 19 community-acquired patients with Legionella pneumonia Fig. 3 Frequency of initial symptoms in patients with Legionella pneumonia
Table 7 Recovery or mortality rates in patients with Legionella pneumonia Died of other unrelated diseases or pneumonia due to other bacterial species Table 8 Chest X-ray findings of 28 patients Group 1. Community-acquired patients without underlying disease(8 patients) Group 2. Community-acquired patients with underlying disease(10 patients) Group 3. Nosocomial patients (10 patients) Died of Legionella pneumonia itself Pneumonia score: Each lung was divided into four areas. Extension of pneumonia lesion on chest X-ray film was demonstrated by the scores from 0 (no lesion) to 10 (full of lesion on both lungs). One area lesion corresponds to score 2, while a half area to score 1.
Table 9 Laboratory data in the 8 patients with community-acquired Legionella pneumonia without underlying disease, 1983-1990 Table 10 Legionella species and serogroups isolated from patients with Legionella pneumonia Table 11 Source of isolation of Legionella species in patients with Legionella pneumonia
Table 12 Results of serum antibody titer estimation against Legionella sp. determined by indirect FA test Determined by microplate agglutination test. Table 13 Antilegionellar treatment in patients with Legionella pneumonia Died of other disease or pneumonia due to other bacterial species
10) Nomura S, Hatta, K., Iwata, T. & Aihara, M.: Legionella pneumophila isolated in pure culture from the ascites of a patient with systemic lupus erythematosus. Am. J. Med., 86: 833 24) World Health Organization: Epidemiology, prevention and control of legionellosis. Memo- from WHO meeting. Bull. WHO., 68: randum 155-164, 1990.
Culture-Positive Legionella Pneumonia in Japan, 1980-1990 Michio ARAKAWA, Chikara NAKAHAMA, Yoshio TAGUCHI, Takashi INAMATSU, Atsushi SAITO, Kohei HARA, Takayuki EZAKI, Eiko YABUUCHI & Yasushi UEDA Woring Party for Legonellosis, Japanese Ministry of Health and Welfare The Working Party for Legionellosis headed by the Japanese Ministry of Health and Welfare processed to standardize the diagnostic procedures for Leginella pneumonia, as the first step to clarify the actual occurrence of patients with this respiratory disease. All the clinical data were collected and analysed on the 28 culture-confirmed patients in Japan during the past 11 years, from 1980 through 1990. The 28 patients were distributed throughout Japan, from Hokkaido to Kyushu. Out of 28 patients, 18 were community-acquired and 10 were nosocomially infected. In 8 of 18 community-acquired patients, any significant underlying disease was not observed. Though it was dominant in the age group in their 60s & 70s, victims were distributed in adults over 20 years of age and even in a new born baby. Only 5 out of 28 patients recovered successfully. From the autopsy findings, in 5 out of the remaining 23 expired patients, Legionella pneumonia seemed to be successfully treated, but other disease or other bacterial pneumonia put an end to the patients. The results of clinical laboratory tests and the efficacy of antibiotics to Legionella pneumonia were essentially the same as those reported in the literature.