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目的 提高临床对老年院内获得性肺外表现军团病的认识。方法 对 9例以肺外表现为主的院内获得性军团病老年患者的临床特点进行了分析。结果 全部患者病程中均未出现明确的肺炎表现 ,而以持续高热、低钠血症、肝肾损害、胃肠道和精神神经症状为主。有效治疗 1～ 2周后病情平稳 ,4～ 5周后痊愈。结论 以肺外多系统损害表现的老年院内获得性军团病可能与老年存在慢性原发性疾病 ,入院后机体免疫功能进一步降低有关。大环内酯类抗生素疗效满意。建议对持续高热怀疑为院内获得性军团病的老年患者可经验性选用或合用大环内酯类抗生素治疗
Objective To improve clinical awareness of acquired pulmonary manifestations of Legionnaires’ disease in the elderly. Methods Nine patients with extra-pulmonary manifestations of elderly patients with acquired Legionnaires’ clinical features were analyzed. Results All patients showed no clear pneumonia in the course of the disease, but continued to high fever, hyponatremia, liver and kidney damage, gastrointestinal and neuropsychiatric symptoms based. Effective treatment 1 to 2 weeks after the disease was stable, 4 to 5 weeks after healed. CONCLUSIONS: Legionnaires’ acquired legion disease in elderly patients with extra-pulmonary multiple organ damage may be associated with chronic primary disease in elderly patients and further decrease of immune function after admission. Macrolide antibiotics with satisfactory results. Recommendations for the elderly patients with persistent high fever suspected of acquired Legionnaires’ Disease may be empirically selected or combined with macrolide antibiotics