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[Suspected "Legionnaire's disease" (author's transl)]
Abstract:
A 46 years old man was admitted to the medical intensive care unit on account of bronchopneumonia with high fever. Because of increasing respiratory insufficiency he was transferred to the anaesthesiological intensive care unit where he was intubated and artificially ventilated until his death 32 days later. Samples of blood, urine and cerebrospinal fluid and tracheal swabs proved sterile when cultured and serological titration methods for the presence of a variety of virus, Chlamydia and Rickettsia gave negative results. Repeated consultations with the bacteriologist finally led to the diagnosis of suspected "legionnaire's disease". Chemotherapy with a great variety of antibiotics failed to bring down the high fever. It was only after 30 days of artificial ventilation that the immuno-fluorescence test for "legionnaire's disease" showed a titre of 1:128 which, according to the literature, constitutes an indication of the presence of this rare disease. A change of antibiotic therapy to erythromycin did not prevent the fatal outcome and the patient died of hypoxic cardiovascular failure.