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An Autopsy Case of Legionellosis Complicated with Cerebellar Ataxia and Acute Renal Failure Hiroaki Yamamoto 1 , Ryuji Shimotori 1 , Teruki Kondou 1 , Takehiko Shimizu 1 , Tsutomu Nakajima 1 1Department of Internal Medicine, Nagano Central Hospital Keyword: レジオネラ症 , 急性腎不全 , 小脳失調 , legionellosis , acute renal failure , cerebellar ataxia pp.923-927
Published Date 1995/9/15
DOI https://doi.org/10.11477/mf.1404901121
  • Abstract
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A 64-year-old man was admitted to our hospital because of cerebellar ataxia. Serum creatinin was 1.1 mg/dl and hyaline cast was seen. Ataxia soon im-proved, but on the sixth day he complained of dyspnea and Laboratory data revealed acute renal failure (s-creatinin 9.2 mg/dl). Chest X-ray showed infiltrative and interstitial shadows. We diagnosed the illness as Legionellosis and initiated hemodialysis. Erythromysin and Rifampisin were used in combination with steroid therapy. The patients symptoms improved and steroid was tapered. After cessation of the steroid therapy. however, his respiratory status deteriorated and mechanical ventilation was required. Serum titers of Legionella pneumophilia (serogroup 1) via indirect immunofluoresence (IFA) increased from less than 1 : 64 to 1 : 128, comfirming the diagnosis. On the 54th hospital day, the patient died of respiratory failure. At autopsy. both lungs showed extensive intraalveolar and intraductal fibrosis, though Legionella were not dis-covered on silver impregnation preparations. The kidneys showed dilated convoluted tubuli.


Copyright © 1995, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1200 印刷版ISSN 0452-3458 医学書院

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