PDF(Pubmed)
Abstract：
A 58-year-old female patient presented with altered mental status, diarrhea, and fever. She was hospitalized for acute kidney injury [AKI] and a patchy right lower lobe infiltrates on chest X-ray. Subsequent testing revealed rhabdomyolysis and a positive urinary Legionella antigen test. Creatinine kinase [CK] level peaked at 512,820 U/L and was managed with aggressive intravenous hydration and appropriate antibiotic treatment. With clinical signs of resolution of pneumonia, the CK level declined rapidly, however renal function returned to baseline only after 2 months requiring hemodialysis in the meantime. The patient was also on tofacitinib which can rarely contribute to rhabdomyolysis. Legionella infection can cause severe rhabdomyolysis and AKI. Timely diagnosis of Legionella-associated rhabdomyolysis, and prompt treatment with aggressive IV hydration and appropriate antibiotics is required to prevent morbidity and mortality.
摘要：
一名58岁的女性患者出现精神状态改变，腹泻,和发烧。她因急性肾损伤[AKI]住院，胸部X线片上右下叶浸润。随后的测试显示横纹肌溶解和尿军团菌抗原测试阳性。肌酐激酶[CK]水平在512,820U/L达到峰值，并通过积极的静脉内水合和适当的抗生素治疗进行管理。随着肺炎消退的临床症状，CK水平迅速下降，然而,仅在需要进行血液透析2个月后,肾功能才恢复到基线水平.该患者还服用了托法替尼，很少会导致横纹肌溶解。军团菌感染可引起严重的横纹肌溶解和AKI。及时诊断军团菌相关横纹肌溶解症,需要积极的静脉水化和适当的抗生素迅速治疗，以防止发病率和死亡率。
