PDF(Pubmed)
Abstract：
BACKGROUND: Infections have been recognized as an uncommon cause of rhabdomyolysis, with evidence indicating a worse prognosis when compared to rhabdomyolysis caused by other etiologies. Diseases caused by Legionella pneumophila can present variably, ranging from mild to severe illness, as is sometimes the case with pneumonia. In particular, the triad of Legionnaire\'s disease, rhabdomyolysis, and acute kidney injury is associated with a significant increase in the morbidity and mortality, with most patients requiring initiation of renal replacement therapy such as hemodialysis. While the exact mechanism of both the muscle and kidney injury in this setting remains unknown, several hypotheses exist, with some research suggesting multiple yet distinct processes occurring in both target organs.
METHODS: In this case report, we describe a 53-year-old African American man who presented with Legionella pneumophila pneumonia complicated by rhabdomyolysis and acute kidney injury. He was treated with aggressive fluid resuscitation and a 2-week course of azithromycin. His clinical status improved without necessitating renal replacement therapy or mechanical ventilation. We postulate that early recognition and treatment were key to his recovery. He was discharged 10 days later without recurrence of rhabdomyolysis at the time of this report.
CONCLUSIONS: While there are several well-established and more common causes of rhabdomyolysis, clinicians should recognize Legionella sp. as an etiology, given its association with significant morbidity and mortality.
METHODS: In this case report, we describe a 53-year-old African American man who presented with Legionella pneumophila pneumonia complicated by rhabdomyolysis and acute kidney injury. He was treated with aggressive fluid resuscitation and a 2-week course of azithromycin. His clinical status improved without necessitating renal replacement therapy or mechanical ventilation. We postulate that early recognition and treatment were key to his recovery. He was discharged 10 days later without recurrence of rhabdomyolysis at the time of this report.
CONCLUSIONS: While there are several well-established and more common causes of rhabdomyolysis, clinicians should recognize Legionella sp. as an etiology, given its association with significant morbidity and mortality.
摘要：
背景：感染已被认为是横纹肌溶解症的不常见原因，有证据表明，与其他病因引起的横纹肌溶解相比，预后较差。由嗜肺军团菌引起的疾病可以有不同的表现，从轻度到重度疾病，有时肺炎也是如此。特别是,军团病的三合会,横纹肌溶解症,急性肾损伤与发病率和死亡率的显著增加有关，大多数患者需要开始肾脏替代治疗，如血液透析。虽然在这种情况下肌肉和肾脏损伤的确切机制仍然未知，存在几个假设，一些研究表明，在两个靶器官中都发生了多个但不同的过程。
方法：在本案例报告中，我们描述了一名53岁的非裔美国男性,他出现了肺炎军团菌肺炎,并伴有横纹肌溶解和急性肾损伤.他接受了积极的液体复苏和为期2周的阿奇霉素治疗。他的临床状况有所改善，无需肾脏替代疗法或机械通气。我们推测，早期识别和治疗是他康复的关键。他在10天后出院，在本报告时没有复发横纹肌溶解症。
结论：虽然横纹肌溶解症的原因有几种，临床医生应该认识军团菌。作为一种病因，鉴于其与显著的发病率和死亡率相关。
方法：在本案例报告中，我们描述了一名53岁的非裔美国男性,他出现了肺炎军团菌肺炎,并伴有横纹肌溶解和急性肾损伤.他接受了积极的液体复苏和为期2周的阿奇霉素治疗。他的临床状况有所改善，无需肾脏替代疗法或机械通气。我们推测，早期识别和治疗是他康复的关键。他在10天后出院，在本报告时没有复发横纹肌溶解症。
结论：虽然横纹肌溶解症的原因有几种，临床医生应该认识军团菌。作为一种病因，鉴于其与显著的发病率和死亡率相关。
