{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T17:00:06Z","timestamp":1771606806461,"version":"3.50.1"},"reference-count":14,"publisher":"California Digital Library (CDL)","issue":"4","license":[{"start":{"date-parts":[[2022,10,24]],"date-time":"2022-10-24T00:00:00Z","timestamp":1666569600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Introduction: Legionnaires\u2019 disease is a multisystem disease involving respiratory, gastrointestinal, and neurologic systems. This is a case of a previously healthy 44-year-old man who was diagnosed with Legionella pneumonia causing acute kidney failure and rhabdomyolysis.\n\nCase Report: The patient presented with four days of chills, shortness of breath, chest discomfort, diarrhea, and myalgias. Laboratory testing revealed hyponatremia, leukocytosis, elevated inflammatory markers, renal failure, and rhabdomyolysis. He was admitted to the intensive care unit for acute hypoxemic respiratory failure, received a course of antibiotics, and more than two weeks of intermittent hemodialysis with full recovery of renal function. The pathophysiologic mechanisms by which Legionella causes rhabdomyolysis and acute kidney failure are not fully understood, although numerous mechanisms have been proposed including direct invasion of myocytes and renal tubular cells. \n\nConclusion: Legionnaires\u2019 disease is one of several infections that can cause rhabdomyolysis and kidney failure. Although rarely described in the literature, it is important for emergency physicians to be aware of this clinical entity in order to implement early diagnostic testing and empiric treatment.<\/jats:p>","DOI":"10.5811\/cpcem.2022.8.57155","type":"journal-article","created":{"date-parts":[[2022,11,16]],"date-time":"2022-11-16T18:40:38Z","timestamp":1668624038000},"page":"288-291","source":"Crossref","is-referenced-by-count":3,"title":["Legionnaires\u2019 Disease Causing Severe Rhabdomyolysis and Acute Renal Failure: A Case Report"],"prefix":"10.5811","volume":"6","author":[{"given":"Andrew","family":"Branstetter","sequence":"first","affiliation":[{"name":"Mount Sinai Morningside-West, Department of Emergency Medicine, New York, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin","family":"Wyler","sequence":"additional","affiliation":[{"name":"Icahn School of Medicine at Mount Sinai, Department of Emergency Medicine, New York, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"29705","published-online":{"date-parts":[[2022,10,24]]},"reference":[{"key":"ref0","doi-asserted-by":"publisher","unstructured":"Fields BS, Benson RF, Besser RE. Legionella and Legionnaires\u2019 disease: 25 years of investigation.\u00a0Clin Microbiol Rev. 2002;15(3):506-26.","DOI":"10.1128\/cmr.15.3.506-526.2002"},{"key":"ref1","doi-asserted-by":"publisher","unstructured":"2.\tGraham FF, Hales S, White PS, et al. Review global seroprevalence of legionellosis - a systematic review and meta-analysis.\u00a0Sci Rep. 2020;10(1):7337.","DOI":"10.1038\/s41598-020-63740-y"},{"key":"ref2","doi-asserted-by":"publisher","unstructured":"3.\tBolliger R, Neeser O, Merker M, et al. Validation of a prediction rule for legionella pneumonia in emergency department patients. Open Forum Infect Dis. 2019;6(7):268.","DOI":"10.1093\/ofid\/ofz268"},{"key":"ref3","doi-asserted-by":"publisher","unstructured":"4.\tMandell LA, Wunderink RG, Anzueto A, et al. Infectious Diseases Society of America; American Thoracic Society. Infectious Diseases Society of America\/American Thoracic Society consensus guidelines on the management of community-acquired pneumonia in adults. Clin Infect Dis. 2007;44 Suppl 2:S27-72.","DOI":"10.1086\/511159"},{"key":"ref4","doi-asserted-by":"publisher","unstructured":"5.\tHollenbeck B, Dupont I, Mermel LA. How often is a work-up for legionella pursued in patients with pneumonia? A retrospective study. BMC Infect Dis. 2011;11:237.\u00a0","DOI":"10.1186\/1471-2334-11-237"},{"key":"ref5","doi-asserted-by":"publisher","unstructured":"6.\tCassell K, Davis JL, Berkelman R. Legionnaires\u2019 disease in the time of COVID-19. Pneumonia. 2021;13(1):2.","DOI":"10.1186\/s41479-020-00080-5"},{"key":"ref6","doi-asserted-by":"publisher","unstructured":"7.\tPosner MR, Caudill MA, Brass R, et al. Legionnaires\u2019 disease associated with rhabdomyolysis and myoglobinuria.\u00a0Arch Intern Med. 1980;140(6):848-50.","DOI":"10.1001\/archinte.1980.00330180122038"},{"key":"ref7","doi-asserted-by":"publisher","unstructured":"8.\tSoni AJ and Peter A. Established association of legionella with rhabdomyolysis and renal failure: a review of the literature.\u00a0Respir Med Case Rep. 2019;28:100962.","DOI":"10.1016\/j.rmcr.2019.100962"},{"key":"ref8","doi-asserted-by":"publisher","unstructured":"9.\tWarner CL, Fayad PB, Heffner RR Jr. Legionella myositis.\u00a0Neurology. 1991;41(5):750-2.","DOI":"10.1212\/wnl.41.5.750"},{"key":"ref9","doi-asserted-by":"publisher","unstructured":"10.\tYogarajah M and Sivasambu B. Legionnaires\u2019 disease presenting as acute kidney injury in the absence of pneumonia. BMJ Case Rep. 2015;2015:bcr2014208367.","DOI":"10.1136\/bcr-2014-208367"},{"key":"ref10","doi-asserted-by":"publisher","unstructured":"11.\tNishitarumizu K, Tokuda Y, Uehara H, et al. Tubulointerstitial nephritis associated with Legionnaires\u2019 disease.\u00a0Intern Med. 2000;39(2):150-3.","DOI":"10.2169\/internalmedicine.39.150"},{"key":"ref11","doi-asserted-by":"publisher","unstructured":"12.\tSimoni C, Camozzi P, Far\u00e9 PB, et al. Myositis and acute kidney injury in bacterial atypical pneumonia: systematic literature review.\u00a0J Infect Public Health. 2020;13(12):2020-24.","DOI":"10.1016\/j.jiph.2020.10.007"},{"key":"ref12","doi-asserted-by":"publisher","unstructured":"13.\tSingh U and Scheld WM. Infectious etiologies of rhabdomyolysis: three case reports and review.\u00a0Clin Infect Dis. 1996;22(4):642-9.","DOI":"10.1093\/clinids\/22.4.642"},{"key":"ref13","doi-asserted-by":"publisher","unstructured":"14.\tMcConkey J, Obeius M, Valentini J, et al. Legionella pneumonia presenting with rhabdomyolysis and acute renal failure: a case report. J Emer Med. 2006 May;30(4):389-92.","DOI":"10.1016\/j.jemermed.2005.07.016"}],"container-title":["Clinical Practice and Cases in Emergency Medicine"],"original-title":[],"deposited":{"date-parts":[[2022,11,16]],"date-time":"2022-11-16T18:40:42Z","timestamp":1668624042000},"score":1,"resource":{"primary":{"URL":"https:\/\/escholarship.org\/uc\/item\/2fz06709"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,24]]},"references-count":14,"issue-title":["Clinical Practice and Cases in Emergency Medicine"],"journal-issue":{"issue":"4","published-online":{"date-parts":[[2022,11,15]]}},"URL":"https:\/\/doi.org\/10.5811\/cpcem.2022.8.57155","relation":{},"ISSN":["2474-252X","2474-252X"],"issn-type":[{"value":"2474-252X","type":"electronic"},{"value":"2474-252X","type":"print"}],"subject":[],"published":{"date-parts":[[2022,10,24]]}}}