Pretibial rash in Legionella pneumophila pneumonia

Legionella pneumophila pneumonia developed in a 46-year-old man, 23 days after receiving a cadaveric renal homograft. A painful, nonpruritic, macular, erythematous rash limited to the pretibial surfaces of both legs appeared on the fifth day of illness. Fever, pneumonia, and rash resolved in association with erythromycin lactobionate therapy.