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Abstract
Case Report
Legionella pneumonia complicated by severe rhabdomyolysis
Ayako Kojimaa,c Takashi Ishiguroa Masami Yamadaa,c Taisuke Shimizub Tatsuro Sanob Noboru Takayanagia
aDepartment of Respiratory Medicine, Saitama Cardiovascular and Respiratory Center
bDepartment of Nephrology, Saitama Cardiovascular and Respiratory Center
cDepartment of Respiratory Medicine, The Jikei University Hospital
ABSTRACT
A 54-year-old man developed high-grade fever, unconsciousness and myalgia, and was admitted to our hospital for Legionella pneumonia. The serum creatine kinase (CK) value had reached 91,110U/L, and we diagnosed him with rhabdomyolysis. We also performed polymixin B immobilized fiber column direct hemoperfusion (PMX-DHP) and continuous hemodiafiltration (CHDF) because his condition was complicated by septic shock and acute kidney injury. Thereafter, the endotoxin levels decreased to less than 5pg/mL from 15.3pg/mL and the serum creatinine (Cr) value increased only slightly in spite of the remarkable serum CK value, which indicated that the introduction of PMX-DHP and CHDF in the early phase was effective in inhibiting an elevation in serum Cr value.
KEYWORDS
Legionella Pneumonia Rhabdomyolysis Acute kidney injury Septic shock
Received 13 Aug 2019 ／ Accepted 6 Dec 2019
AJRS, 9(2): 137-140, 2020
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