Legionellosis: symptoms,ʻike, lapaʻau

Legionella - he genus o ka koʻohune e hiki i loa pneumonia a me ka alveolitis i loko o nā mākua. First kākau'ōkuʻu nā lā hoʻi i ka 1976 makahiki, ka wā i loko o Philadelphia manawa i loa pneumonia i waena o ka 4.400 i komo o ka Ahaolelo, "American Legeona" make 35 veterans. Total 221 kanaka i ka maʻi, a me ka make ana o ka maʻi, he 15,4%. I ka mea - legionellosis. Na mea a pau e pili ana i na kumu, symptoms a me ka hana ana o keia maʻi i imi e pohihihi mai rikketsiologi Makdeyt a me Shepard. A ma hope o 6 mahina mai ka la aku o ka outbreak o ka pathogen hōʻike 'a me ke imi ana e hakakä ia.

Microbiological characterization o ka causative Agena

E like me ka mea huli mai hope haumana, kauoha ae la ia e ka bacterium Legionella pneumophila. Ka mea, no a hiki i ka waeʻano o anaerobes i ke ola i loko o ka 'ia me ka oxygen. Ia, aole ia i hana i spores a me capsules, paa microbeʻaʻohe halepaahao paia, a pili ia i gram io? Ueo. Ma ka Ia deficiency o kona pūnao puʻe wale akula kēlā, e nana aku no ka aoao e ola pili me kanaka haʻawina.

Mua, Legionella mea he intracellular parasite, kahi e ua palekana mai ka'ōnaehana paleʻea nenoaiu. ʻO ka lua,ʻo "e kali ana" kanaka legionella ma unexpected wahi no ia ia, ma ka mea, manao hoʻomaha - i loko o ka nui, ma ka 'auʻau' wai ma luna o ka pā, a kaa i hoʻolako pono me ka lewa-hoʻoikaika kino pa alima. Mehana ka wai a me ka mea hiki ke hooheheeia paipu e ka mea e hiki ai i ka mahuahua koʻohune. ka mea, i kekahi hana ma ka hoao ana me ka cyanobacteria i loko o ka mehana wai a me nā paipu me ka mehana ka wai. No keia kumu, o ka hola 16% o nā mea a pau pneumonia hoʻomohala i ke komo ana o kekahi a oi? Ueo o Legionella.

A oaeii, aia nō ma kahi o 50 ke kanana nei o koʻohune o ka genus pili i ka helu o tasonomicheskomu pneumotropic meaola genus Legionella. Ka mea, hoʻonāukiuki legionellosis (Legionnaires 'maʻi, a) ke kumu, symptoms a me ka hana ana o literate ano i keia manawa, i ike ia. Ano, e pili ana i ka laha o ka maʻiʻaʻai, pathogen AaOIeIOUIeXAOAaIN hiʻona me ka meaola, like hoʻi me ka hooulu ana o ka maʻi i lawa 'ike. Ua i apono 'oe e ho'āʻo i ka ho'ēmi i make, mai Legionella pneumonia a me ka alveolitis.

Morbidity a me ka propagation ano

Ma ia he maʻi like legionellosis, symptoms a me ka oolea o keʻano hilinaʻi nui ma luna o nā 'ano o ka meaola. Me ka lawa'ōnaehana paleʻea pale ka hoʻokōʻana o kanaka, a hiki i ka hoopuka moakaka hui 'hiki ole kiʻi maʻi. Eia naʻe, a me ka emi ana o kona oihana ka pahiki o ka maʻiʻaʻai, piʻi pū na manawa he nui. A, immunocompromised nā mea maʻi, me HIV-e pili maʻiʻaʻai, na symptoms o Legionnaires 'maʻi mea nui hou loa a me ka hou wā o ka maʻi.

Ke bacterium komo i ke kino ma ka naehana'ōnaehana , a ma ka palapū. Keʻano mua o ka naehana droplets. I ka manawa kūpono a kaʻana like me Legionella wai droplets i kona epidemiological ano. Holo nōhie, o ka poe mai kanaka a pau i loko o ke kime hana i loko o ka ia keena, ina lākou e hoʻonele ua kuu iho la. Hoʻokaʻaʻike aoao Ua oi pohihihi, akā,ʻaʻole ke hoʻokoe '. Ma kēia hihia, na symptoms o Legionnaires 'maʻi Tuamotu, oa i loko o ka wahi o kaʻeha a me ka ili poino, a me ka nenoaia - na hoailona o ka intoxication.

Kanawai o ka maʻi pili ole wale me ke 'o ka e hoʻonele, akā, no hoi me kona mau makahiki ano o ka pae ana o kanaka. Iho la ka manao e nui pinepine, a oi seriously ino na kanaka elemakule makahiki 40 a oi. Wahine a me na keiki e maʻi emi pinepine. Kēia hiʻona apono 'oe e maopopo ma waena o legionella pneumonia ma Mycoplasma. Mycoplasmas pinepine ui kanaka e loli ai, nānā 'ole o ka wahine.

Ka lapaʻau papa o ka maʻiʻaʻai ma Legionella

Ma na maʻi like legionellosis, me ka symptoms mai ole ana mahope mai o ka puka mua ka leo, a ma hope o ka incubation wā. Ka mea, e lawe ma kahi o 2-10 lā: i loko o kēia wā o ka manawa i loko o ke kino multiplies legionella, akā, pathological keʻano o ka hanaʻana ha awina mea haʻahaʻa, a ke kumu no nīnūnē (subclinical) hoailona. Maʻiʻaʻai ia lŘlŘ a me ka oluolu ala, ua wehewehe aku ma ka maʻi palū-e like maʻi pale, a ma ke 'ano o ka pneumonia me ka loa naehana'āpana.

Keʻano mua ua pili ia me ke kahe o ka legionellosis maikai aiiay hiki o ka meaola. E like me ka hopena o ka hui 'ana me ka huʻi naehana maʻiʻaʻai hoʻomōhala legionellosis ma bronchitis type. Kēiaʻano o ka lapaʻau papa ua kapaia Pontiac kuni. I ka lua o kaʻano o ka maʻi - Legionella pneumonia. He oi loa, a ia lŘlŘ me kiʻekiʻe make.

Ua mea waiwai 'ana i kumumanaʻo ana Pontiac kuni - ma ka liʻiliʻi loa i kekahi maʻi nui, ia mea wale pilikia emi legionellosis. Legionnaires 'maʻi (maʻi symptoms i'ālike me ka hiʻona o nā atypical pneumonia) mea he kīnā o Legionella pneumonia, ke koʻikoʻi, pinepine ona no ka hoʻomanawanui.

Ka Mea Maluna mea i pono, e līkaia legionellosis, i mea ka loa loa symptoms. Ua alveolitis - He nui ke ano o ka pneumonia e boosts i ke kino o kaʻawahia, a ma ka hoemi i ka likelihood o ke ola. Ua i mea e hoolako mau ano o ka legionellosis, ke kaumaha ma muli o ka wahi o ka hanana. It nosocomial legionellosis a me ka sporadic, i mea kaiāulu-lilo. Haukapilaʻike, o ka legionellosis ua mana wale ina ka lapaʻau hoailona iʻikeʻia ma hope o 2 a oi lā, mai ka manawa o ka makahiki ma ka wahi mokuna.

Ano symptoms o Pontiac kuni

Pontiac wela mea i laʻana o ka pele o ka akemāmā maʻi e like me Legionella pneumophila. Symptoms o keia ano legionellosis e hoohalike ai maʻi palū a parainfluenza kaumaha: hoomanawanui o ka wawahi kiʻekiʻe wela (38-39 ° C), i akaka ma hope ma kahi o 36 hola ma hope o ka loiloi mua waiū. I aʻoʻia, pili myalgia, headache, maloo cough huli no. Kēlā wā i kēia wā, ka oi aku me ke kuni maluna o 38 degere, e hoʻomōhala ana i ka luaʻi.

mea e hopohopo nei hele pū ana symptoms pu ia e mahuahua ana wela: makewai, maloo waha, ua hoʻemi mimi auaiaea. Nō hoʻi,ʻeha i loko o ka pahu, oiai keia hiʻona mea oi nā ke Legionella pneumonia mea e loli ai ka pleura, ma mua me Pontiac kuni. Kēlā wā i kēia wā ma luna o ke kāʻei kua o ka intoxication i Konakele. Photophobia, hoʻopōʻino manaʻo a me ka lehulehu, akā, ma hope o ke ola, e like me ka rula, neurological complications mea,ʻaʻole i loaʻa.

He noteworthy e like legionellosis mea: na symptoms i ole koke'ē aʻe, e like me ka mea mua hui 'ana me ka maʻiʻaʻai. A hookahi i ke kino i loaa lawa pathogens ka mea, hōʻike. Ke hoomanawanui manao ia e ia a pau o ka lapaʻau hoailona i ikeia'ku me ka mua,ʻo ia hoʻi, e ku e ka kāʻei kua o ka nohona ma ola. Uaʻo kona mau mea hoʻololi, a hiki haawi ala i kāna hanaʻike, "meningitis", no ka mea, i kēia maʻi i hoʻomaka me he maʻi palū.

Symptoms o Legionnaires 'pneumonia

He nui symptoms o Legionnaires 'maʻi, Legionnaire ka maʻi, i hoʻomaka ai ma mua o ka h ÷ ike, no ka mea, e ku e ia i ke kāʻei kua o immunological kāna hana, i ka incubation wā hiki mau mai i 3 pule. Kēia manawa ua kapaia prodromal manawa , a hōʻike makaainana hiʻona: ke alo o ka poe liilii, mai kuni, Muscle nawaliwali, sweating a me ka pokole o ka hanu ma ka malamalama e haawe, me ka puʻu. Naʻe, ka hapanui o ka incubation au i wahi wale no 2-10 lā. A laila, a pau na symptoms me prodromal manawa, oa hoi e ku i ke kāʻei kua o ka nohona ma ola, e like me ka ka ina me Pontiac kuni.

Ma ia he maʻi like Legionella pneumonia (legionella), na hoailona a me kā lākou mau hōʻike e ole hilinaʻi ma ka immunological reactivity o ke ahonui, a me kona physical ahonui. I ka maʻi ua lawe ua hoopili i, a hiki ke alakai i ka make. Initially, he mea kuni e pili ana i + 39-40 degere, a i ole ia, ina o ka hoʻomanawanui poino i immunodeficiency pili me HIV a me cytostatic Inc. Together me kuni, hoʻokahi nō ka cough a me ka ehaeha i loko o ka pahu. Initially wale cough maloʻo a me ka sputum ka mea, i kaawale.

Ma ka ia kokoke koke hoʻomaka e hoʻopilikia eha i loko o ka pahu, no ka mea, o ka maʻiʻaʻai (Legionella) ke kumu fibrinous pleural effusion a me na alveoli. A pau kēia mau mea pepehi Legionellosis: symptoms,ʻike, a me ka lapaau prognosis no keia mea i questionable. Together me ka ikepili hiʻona o ka maʻi i ke ahonui i dyspnea,ʻawahia kŰia, naehana alkalosis, ano hoomainoino i ka papa kuhikuhiE symptoms, a emi i ka regenerative nona iho o ke kino.

Common hiʻona o kaʻike, o ka legionellosis

I ka mea, he maʻiʻaʻai me legionellosis,ʻike, a me ka hana i kā lākou iho ka manaʻo pohihihi. Mua, me na lako a pan no ka chromatography a Elisa reliably ho oholo i ka pathogen mea aneane hiki ole i. ʻO ka lua,ʻo ina kekahi o ke koho Legionella sputum pilikia. Ke kolu, me ka manawa kūpono o ka ike loea hoʻoholo o ka koʻohune e kena ae i ka maʻi, i ka kauka, e hoʻohana i ka Hoʻokolohua-lactam antibiotics like me ka mea ana i empirical antimicrobial Inc.

No ka hapanui o ka Hoʻokolohua-lactam hoʻopale legionella no ka mea, o kona intracellular wahi i loko o ke kino. Ua hoi ho'ēmi i kā ka laulā o ka e hoʻonele i ke kaua maʻiʻaʻai a maoli he i ka nui o ka toxins mea i systemic detrimental loa. No ka mea,ʻike, E e like hoʻokēʻai me hiki. Inā i ka manawa kūpono o ke keʻena hoʻokolohua hōʻoiaʻiʻo nō o ka causative Agena o Legionnaires mea i loaʻa, mai ke kauka i hoakaka ia empiric lapaau regimen me ka hana o ka macrolide a fluoroquinolone antibiotics.

Heluʻike, o Legionella pneumonia

Koke ike i ka maʻi, no ka mea, o kona comparatively haʻahaʻa alapine (frequency), ia mea kokoke ole. Eia hou, aia nō ma kahi o 10 nā mea palahēhē, i ke kahe i loko o ka loiloi mua au reminiscent o legionellosis. Nā symptoms a me ka hana ana o Legionnaires 'No laila, hoʻomaka me empirical noaia - paha o ka elua a oi ka laulā-pae antibiotics me kā mākouʻaoʻao pale genera o microorganisms. lawe Ua hoi mai a me kaʻike, physical, ma muli ma ka loiloi 'o kaʻikepili e e loaa me ka mea ninaninau o ka hoʻomanawanui hiki.

Ka mua ana o ka legionellosis - ke kuni, nae ia mea i maopopo. Ma mua hui 'ana me ka hoʻomanawanui luku kaumaha i hoʻomaka koke e holumua ai dyspnea a me ka uku paneʻe, kekahi manawa i ka 40 breaths no minuke. Once hoohihiaia cough me phlegm. Ke hoomanawanui i ka hanu nui, akā, ma hope hoʻomaka e hookoe mai i ka pahu ma muli i ka ulu pleurisy. I ka legionella pleurisy e hoʻomōhala ana i wikiwiki ma mua o pneumococcal pneumonia.

Auscultatory ano o ka legionellosis

I physical na hoailona o ke alo o auscultatory hou. Maʻi o loli nui mau mea o ka akemāmā, IeAUPIIe, IAa IO he okoa kaʻana like 'ana. No hoi, ina he hoʻokahi wale nō ma paʻi loiloi i legionellosis, ke kumu, symptoms,ʻike, a me ka hana e e hou'ē aʻe. Ka wahi o keia:ʻano nui e loli ai i ka lalo lobes, a me ka pinepine kekahi o ia mau mea. Haʻalele - aie i ka mea i kona ololi lobe bronchi a me na lala, mai ka papa kuhikuhiE bronchus ma ka huina, emi hoomanawanui. Mainua pono haʻahaʻa lobe ua wehewehe aku ma ke akea, a pōkole lobe bronchus, o ka a no ka maluhiluhi, mai ka papa kuhikuhiE kokoke pololei. Mau lepo (particles) hāʻule oi pinepine ia ma mua i loko o ka lima hema ma lalo lobe, naʻe ka mea, o ka ka 'ikepili helu wale nō i ole e hiki loa pololei rula.

Ma physicalʻike, hōʻike crepitus. He oiʻeluaʻaoʻao, i mea ole pinepine ana. It E e ike okoa mai congestive pulu finely maʻi, a i lohe ai me ka maʻi naʻau ole me symptoms o ka loli ka mālama i loko o ka ia maʻiʻaʻai. Aka hoi, olelo physical hoʻoholo 'i kaʻike, hiki ole ke kūkulu. Inā ua nele ia e complemented e vocal a me ka keʻena hoʻokolohua ho'āʻo ma.

lapaʻau 'pneumonia

Elua o ka loa waiwai PalekanaEND_LINK hoʻopololei ki ina hana like nā: bronchoscopy a me ka radiography. Pinepine i loaʻa lua o ka hana e loaa i ke kiʻi o nā nā'aʻaʻa o ka pahu, a me ka wela mau mea. Ma radiographs ma frontal wānana i kekahi 'lawa ka nui lobular malu, aole ia e hoʻopili like me ka nui o ka ipu ahi, i nā oaeuiinoe ma hope auscultation.

Ke kiʻiʻelua i ka mau o ka li nui lehulehu, kekahi manawa mau no ia, a me ka mea, merge i kekahi i kekahi. More kākaʻikahi ike pleural fibrin uhi hapa ma ka hanana o Legionella li nui. Ma keia hihia, i ka manawa ia ma ka radiography i loaa e hooiaio ai i ka hoʻomanawanui i li nui o ka akemāmā'aʻaʻa, ke kauka e hoi mai i paipai i ke alo o Legionella.

Bronchoscopy mea he emi waiwai ala, ma ka kekahi manaʻo nui nō ia. He nui no ka palena pauʻike. E ho ohana ia mea ana e lawe i ka bronchoalveolar lavage, a me ia e hiki ke kuhikuhi i ka microbe mai ana i ka pneumonia. O ka papa, no ka bronchoscopy, ma laila nō kekahi contraindications, kekahi o i o ka oolea o ka hoʻomanawanui ka kulana.

Keʻena hoʻokolohua PalekanaEND_LINK Nā Papahana

Gold hae no kaʻike, o infectious maʻi - bacterioscopy, koho koʻohune a me kona mahi. Ma ka hana ka mea, ua hooiaio ia pathogenic microbes i loko o ke kanaka kino a me konaʻikena moku'āina no a hiki i keia. Akā, ma ka hihia o ka legionellosis bacterioscopy kokoke hiki ole, no ka mea, me Legionella i haukaʻe i haule like nā meaola i hiki i pneumonia, i ke kanaka hoʻokahi paha aggravate kona papa. No ka mea, increasingly hoʻohana chromatography a me ka 'ūhū immunoassay.

Lapaʻau o Legionella pneumonia a me Pontiac kuni

Oihana o Health a me ka lapaʻau koi no ka pulmonology na Hola Pūnaewele i keia la i alakaʻi i bronchitis a me ka pneumonia E e hana me ka hoʻohana 'ana o nā' ano o antimicrobial Luna o laulā pae o ka hana. Kekahi o ia mea he aminopenicillin paha cephalosporin. Ka lua oʻano mea he macrolide antibiotic. Appropriateness mua hoaponoia mai likelihood o ka hele pū ana microflora, no ka mea hoi macrolides hana ku e Legionella.

Ua Ua manaoio ia ma ka hou ana i macrolides ( "midecamycin", "Azithromycin", "Erythromycin", "Clarithromycin"),ʻeleu iā Legionella a me fluoroquinolones a me rifampicin. I waena o fluoroquinolones koho "ciprofloxacin", "ofloxacin", "Moxifloxacin", "Gatifloxacin" "Levofloxacin". "Rifampicin" a me ka "Doxycycline" kēlā wā i kēia wā hiki ke hoʻohana. I hoonoho ia ma na kēia me ka hui pu ana o ai ':

• Lunamakaainana Hoʻokolohua-lactam pae like ka hehee ai empirical noaia - "ceftriaxone" 1 gram intramuscularly palua i ka lā ma ka 12 hola;
• macrolide o loko ( "Azithromycin 500" koke i ka lā a "Erythromycin 500" 6 pa \ lā, a me "Clarithromycin 500" palua i ka lā, a "midecamycin 400" 3-4 manawa i ka lā);
• fluoroquinolones me ka ineffectiveness o ka mua papa elua o ka ai '( "Ciprofloxacin 400» intravenously 2-3 manawa i ka lā, "Levofloxacin 500' maloko, kekahi manawa i ka lā," Moxifloxacin 400 "koke i ka lā).

E like me ka hoike ana, ka mea mua laina ai 'i macrolides. Eia naʻe, ma muli o ia ka mea i ka mea, uhi wale i ka nui hana o koʻohune, haalele ia ia e ola'na (bacteriostats), a me kēia legionellosis 'ole' ē aʻe SARS ka mea, ua pono e hoʻohana fluoroquinolones. Macrolides mea ma ka mahele lāʻau kiʻekiʻe wale, a wale kekahi o ia ( "midecamycin" a me ka "Roxithromycin") hiki i ka bactericidal hopena. E like ka wā ka mea, ua hāʻawi i ka 'O ke kaulike, a kupono noaia o antimicrobial Inc, i ka hoʻomanawanui nele hoʻokomo ea kākoʻo, e like me infusion Inc e paʻipaʻi i infectious-ʻawahia kŰia.

Pinepine keia iapaau ana ua lawe mai i loko o ka mālama nui malama mokuna, ma ka hoʻomanawanui mea 3-5 lā ma mua o ke noaaeeecaoee. A laila, lapaʻau ua mālama 'ia i loko o ka infectious pahu paha ma ka pulmonology. A, no ka loaa i ole correlate me ka hopena o ka X-Ray: infiltrative aka i loko o nā kiʻi e pili ana i ka mahina a oi. A me nā mea a pau Legionella pneumonia lapaʻau mau lā ma kahi o 20 a oi. Ma hope o hookuuia, i ka hoʻomanawanui E hoi e malama outpatient, e hoʻopaʻi ana naʻe i ka kūloko kino eha manawa o ka makahiki.