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作者复习了1977-1985年内157例恶性血液病患者的尸解资料(各类淋巴瘤100例,浆细胞瘤25例,骨髓增生性疾病16例,急性白血病16例),发现70例(44.6%)患有肺炎,其中16例(22.9%)的肺组织切片经直接荧光抗体法试验(DFA)证实肺炎系军团病菌所致。这16例患者中13例的肺组织切片以常规染色法检查则未发现病原菌。16例尸检证实为军团病肺炎的病人中,5例生前临床已怀疑有军团病,且经血清学检查及尿中发现军团病菌抗原而确诊。作者认为:军团病菌是恶性血液病患者肺炎的主要病原菌。血清学检查不能作为早期诊断的手段,发病24小时内可在尿中发现军团病菌抗原,阳性率达
The authors reviewed 157 autopsy data (100 cases of various types of lymphomas, 25 cases of plasmacytoma, 16 cases of myeloproliferative diseases and 16 cases of acute leukemias) from 157 patients with hematologic malignancies between 1977 and 1985. Seventy patients (44.6% ) Had pneumonia, of which 16 (22.9%) of the lung tissue sections by direct fluorescent antibody test (DFA) confirmed pneumonia caused by Legionella bacteria. Thirteen of the 16 patients who were examined by routine staining did not find pathogenic bacteria in their lung tissue sections. Among the 16 patients confirmed as autopsy by pneumonia, 5 had clinically suspected Legionnaires’ disease and were confirmed by serological examination and antigenicity of Legionella in urine. The authors think: Legionella bacteria is the main pathogen of pneumonia in patients with hematological malignancies. Serological tests can not be used as an early diagnosis, within 24 hours of onset of Legionella bacteria antigen found in the urine, the positive rate of