Legionnaires' disease and acute renal failure: case report and review

The case of a 26-year-old man with pneumonia due to Legionella pneumophila associated with acute renal failure is presented, and the English-language literature on legionnaires' disease is reviewed. For this review, acute renal failure was defined as rapid deterioration in renal function indicated by a rise in levels of blood urea nitrogen and creatinine with or without the presence of oliguria. Our patient experienced renal failure and underwent hemodialysis. His condition gradually improved after treatment of legionnaires' disease with erythromycin. Biopsy of the kidney showed acute tubulointerstitial nephritis. Immunofluorescence microscopy demonstrated the presence of L. pneumophila serogroup 1. The laboratory findings suggested rhabdomyolysis. To our knowledge, this is the first case report of a patient with legionnaires' disease who recovered from acute renal failure and in whom the presence of L. pneumophila was demonstrated, and we believe it is the first case in which morphology of the kidney demonstrated the presence of L. pneumophila in a patient with legionnaires' disease, rhabdomyolysis, and renal failure.