Legionnaires' disease. Report of a case with unusual manifestations

The multisystem involvement in Legionnaires' disease commonly includes pulmonary, renal, hepatic, gastrointestinal tract, and neurologic manifestations, but except for the lung the mechanism of disease has not been defined. Circulating toxins are most commonly implicated. A nonfatal case is reported here that had unusual renal and neurologic findings. The renal failure was associated with urinary findings indicative of a glomerulitis, and the major neurologic manifestation was a polyneuropathy. The complications in this case suggest an immunologic mechanism for the extrapulmonary manifestations of Legionnaires' disease.