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[Legionella infection with rhabdomyolysis]
1Medicinsk afdeling C, Odense Universitetshospital.
Abstract:
Rhabdomyolysis complicating infection with Legionella pneumophila has previously been reported and may in some cases have led to acute tubular interstitial necrosis. We report a case of severe Legionnaires' disease complicated with rhabdomyolysis, myoglobinuria and neurological symptoms. Treatment with erythromycin and rifampicin was initiated early in the course of disease. The myoglobinuria was treated with forced diuresis and alkanization and renal failure did not develop. The frequency of rhabdomyolysis as a complication to Legionnaires' disease is not known. In addition, the pathogenesis and possible risk factors have not yet been determined. Considering the seriousness of this complication and until further investigations have been performed we recommend that routine determinations of creatine phosphokinase are performed in the evaluation of these patients.
Insights
Severe Legionnaires' disease can cause rhabdomyolysis, a serious muscle breakdown. Early treatment and supportive care prevented kidney failure in one case, highlighting the need for creatine phosphokinase monitoring.
Area of Science:
- Infectious Diseases
- Nephrology
- Neurology
Background:
- Legionella pneumophila infection, causing Legionnaires' disease, can lead to complications.
- Rhabdomyolysis, a condition involving muscle breakdown, has been previously associated with Legionnaires' disease.
Observation:
- A case of severe Legionnaires' disease presented with rhabdomyolysis, myoglobinuria, and neurological symptoms.
- The patient received early treatment with erythromycin and rifampicin.
- Supportive care including forced diuresis and alkanization was administered for myoglobinuria.
Findings:
- The patient's myoglobinuria was managed effectively, and acute renal failure was averted.
- The frequency, pathogenesis, and risk factors for rhabdomyolysis in Legionnaires' disease remain undetermined.
Implications:
- Routine creatine phosphokinase level monitoring is recommended for patients with Legionnaires' disease due to the risk of rhabdomyolysis.
- Further research is needed to understand the mechanisms and identify risk factors for this severe complication.