Legionella pneumonia complicated by rhabdomyolysis

BMJ Case Rep. 2019 Jun 20;12(6):e229243. doi: 10.1136/bcr-2019-229243.

Abstract

Legionnaires' disease is a recognised but rare cause of rhabdomyolysis. It can be further complicated with renal impairment. In this case report, we describe a previously healthy, semiactive 50-year-old man who within days was reduced to having periods of dyspnea after minutes of walking in addition to near fatal acute renal failure. He was found to have the rare triad of Legionella pneumonia, renal failure and rhabdomyolysis, which is associated with high morbidity and mortality. He was treated according to guidelines with azithromycin monotherapy and aggressive fluid hydration. 20 days after admission, the patient was walking independently and discharged home.

Keywords: acute renal failure; infectious diseases; musculoskeletal syndromes; pneumonia (infectious disease); pneumonia (respiratory medicine).

Publication types

  • Case Reports

MeSH terms

  • Acute Kidney Injury / etiology
  • Anti-Bacterial Agents / therapeutic use
  • Azithromycin / therapeutic use
  • Diagnosis, Differential
  • Humans
  • Legionella pneumophila / isolation & purification
  • Legionnaires' Disease / complications*
  • Legionnaires' Disease / diagnosis
  • Legionnaires' Disease / drug therapy
  • Legionnaires' Disease / microbiology
  • Male
  • Middle Aged
  • Pneumonia / complications*
  • Pneumonia / diagnosis
  • Pneumonia / microbiology
  • Rhabdomyolysis / etiology*
  • Rhabdomyolysis / microbiology
  • Rhabdomyolysis / pathology
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents
  • Azithromycin