A case of Legionella pneumonia associated with acute renal failure

DOI Web Site 17 References
  • Nakatani Shinya
    Department of Renal Medicine, Ohno Memorial Hospital Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine
  • Inariba Hiromi
    Department of Renal Medicine, Ohno Memorial Hospital
  • Kumeda Yasuo
    Department of Renal Medicine, Ohno Memorial Hospital
  • Inoue Keisuke
    Department of Renal Medicine, Ohno Memorial Hospital
  • Sai Yoshinori
    Department of Renal Medicine, Ohno Memorial Hospital
  • Okamura Mikio
    Department of Renal Medicine, Ohno Memorial Hospital
  • Nishizawa Yoshiki
    Metabolism, Endocrinology and Molecular Medicine, Osaka City University Graduate School of Medicine

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Other Title
  • 急性腎不全を併発したレジオネラ肺炎の１例
  • 症例報告 急性腎不全を併発したレジオネラ肺炎の1例
  • ショウレイ ホウコク キュウセイ ジンフゼン オ ヘイハツ シタ レジオネラ ハイエン ノ 1レイ

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A 50-year-old man was admitted to our hospital with pyrexia of 38°C and dyspnea. Chest X-ray film showed infiltration of the right lower field, and the serum creatinine was 4.01 mg/dL. We suspected atypical pneumonia, and cefozopran (CZOP) and minocycline (MINO) therapy was started. Although his general condition improved, renal function gradually deteriorated without an increase creatine phosphokinase level. On the 2nd hospital day, hemodialysis was started to treat acute renal failure. Renal function was improved after two hemodialysis sessions. On the 5th hospital day, a urinary Legionella antigen test proved positive ; consequently, the antibiotic therapy was switched to ciprofloxacin (CPFX) and MINO. Finally, on the 12th hospital day, the patient was discharged from our hospital without renal dysfunction. Rhabdomyolysis is often seen in certain cases of Legionella pneumonia associated with acute renal failure. However, in the present case, the patient's creatine phosphokinase level was normal ; therefore, rhabdomyolysis was not the cause of the observed acute renal failure. We consider that endotoxemia, direct microbial toxicity, inflammatory cytokines, or NSAIDS could have caused this patient's acute renal failure.

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