Early diagnosis and treatment of Legionella pneumonia is essential. We examined the clinical features of 9 patients with Legionella pneumonia in our hospital and here we report the characteristics of community-acquired pneumonia in this rural area to facilitate diagnoses of Legionella pneumonia. All patients were male, had low CO2 levels, hyponatremia, and a high creatine phosphokinase levels. Eight patients had high aspartate transaminase and alanine transaminase levels, and 7 had a low estimated glomerular filtration rate. The source of infection was determined in 6 patients: hot springs (n = 4), a refrigerated vehicle (n = 1), and well water (n = 1). Six patients were diagnosed using the urinary Legionella antigen test, and 3 were diagnosed using loop-mediated isothermal amplification (LAMP) of sputum samples. In such patients, it is therefore important to examine urine antigens and carry out polymerase chain reaction analysis (or LAMP) of sputum.

We report a rare case of anaphylaxis due to caffeine intake. A 27-year-old woman suffered her first episode of anaphylaxis and a positive skin prick test suggested that the anaphylaxis was due to an IgE-mediated hypersensitivity reaction to caffeine. She was diagnosed with caffeine allergy and has not had an allergic reaction after avoiding foods and drinks containing caffeine. Although caffeine is known to have antiallergic effects, this case shows that caffeine can be an allergen and cause anaphylaxis.
Adult ; Anaphylaxis ; Caffeine ; Female ; Food Hypersensitivity ; Humans ; Hypersensitivity ; Hypersensitivity, Immediate ; Skin