[Community-acquired pneumonia with rhabdomyolysis]

We assessed the frequency and etiology of rhabdomyolysis in patients with community-acquired pneumonia. In 594 patients with community-acquired pneumonia whose serum CPK were measured, 25 patients (2.4%) were found to have rhabdomyolysis. Including 4 patients with mixed infections, the etiologies in 25 patients with community-acquired pneumonia with rhabdomyolysis were as follows: Legionella species, 11 patients (44%); Influenza virus, 6 (24%); Streptococcus pneumoniae, 4 (16%); Chlamydia psittaci, 3 (12%); Mycoplasma pneumoniae, 2 (8%); unknown 3 patients (12%). The rates of rhabdomyolysis for each etiologic category were as follows: Legionella species, 26.8% (11/41); Chlamydia psittaci, 21.4% (3/14); Influenza virus, 9.5% (6/63) ; Streptococcus pneumoniae, 4.7% (4/85);Mycoplasma pneumoniae, 3.1% (2/65). Renal dysfunction with a serum creatinine concentration greater than 1.5 mg/dl occurred in 6 patients (24%). Our experience illustrates that 5 pathogens can cause rhabdomyolysis in patients with community-acquired pneumonia. Legionella species are the most common organisms followed by Influenza virus, Streptococcus pneumoniae, Chlamydia psittaci, Mycoplasma pneumoniae.