A Case of Legionella Pneumonia Successfully Treated with High-dose Ciprofloxacin

• Published in: The Kitakanto Medical Journal Vol. 61; no. 2; pp. 169 - 174
• Main Authors: Hashizume, Yutaka, Suzuki, Kuniaki, Kawata, Tadayoshi, Endou, Katsuaki, Horie, Takeo, Takise, Atsushi
• Format: Journal Article
• Language: Japanese
• Published: The Kitakanto Medical Society 01.05.2011
• Subjects: Ciprofloxacin; Gimenez steining; Legionella pneumonia; Legionella pneumophila serogroup 2; Legionella urinary antigen detection test
• ISSN: 1343-2826; 1881-1191
• DOI: 10.2974/kmj.61.169

A 38-year-old man presented at a nearby hospital in the middle of June, with a complaint of fever and cold symptoms since early June and dyslalia in the middle of the same month. A chest radiograph at the examination showed a infiltration in the right lower lung field. As he has been a staff of a bathing institution, Legionella pneumonia was suspected. He was admitted to the hospital, although Legionella urinary antigen detection test was negative. On the next day, he had a disturbed consciousness and dyspnea, was referred to our hospital. Although Gimenez steining and Legionella urinary antigen detection test were negative, Legionella pneumonia was suspected, he was given CPFX. In the process, Legionella serogroup 2 was detected, he was given a diagnosis of Legionella pneumonia. As he responded poorly to the initial dose : 600mg/day of CPFX, increased dose : 1200mg/day was given. Then he showed remarkable improvement. From this experience, we consider that AUC and Cmax are important indicators to get effective antibacterial response, when CPFX is given. In general, Japanese dosage are set lower than foreign ones. For poorly responded case of CPFX treatment, we consider that dose increasing should be practiced.