Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0023241 (Legionella)
 6,990 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 47-year-old man was admitted to our hospital for community-acquired pneumonia complicated with acute renal failure. Legionella pneumophila serogroup type 1 was grown in BCYE (buffered charcoal yeast extract) agar for sputum culture. Although his respiratory illness responded to intravenous erythromycin therapy, renal failure worsened and necessitated hemodialysis. Renal biopsy showed profound tubulointerstitial nephritis. After initiation of steroid therapy his renal function improved and he was discharged thereafter. These findings suggest that in Legionnaires' disease with acute renal failure, tubulointerstitial nephritis should also be considered and steroid therapy may be an effective modality for the renal complication.
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PMID:Tubulointerstitial nephritis associated with Legionnaires' disease. 1073 34

A 67-year-old male was admitted to our hospital due to a high fever with abnormal shadows on chest X-ray films. On admission, his laboratory data showed hyponatremia, rhabdomyolysis and liver dysfunction. Encephalopathy, acute renal failure and respiratory failure developed, despite fluid management and antimicrobial therapy. His condition worsened rapidly in a few days enough to require mechanical ventilation. Legionnaires' disease was suspected, because pneumonia was found to be associated with multiple organ dysfunction. Intravenous erythromycin and methylprednisolone were administered. The patient's condition was rapidly improved, although he needed hemodialysis for 30 days. Later, indirect fluorescent antibody testing of the patient's serum against Legionella pneumophila was definitely positive (1:1024). We reported the first case of severe Legionnaires' disease in Miyazaki Prefecture, Japan.
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PMID:[A case of severe Legionnaires' disease complicated by rhabdomyolysis, acute renal failure, liver dysfunction and encephalopathy]. 1114 85

Legionella pneumophyla is the agent responsible of Legionnaire's disease. It appears as a severe pneumonia and often requires admission in Intensive Care Unit. In literature, renal failure is reported to occur in 15 percent of Legionnaire disease and this event induce a mortality over 50% of these cases. The authors describe a case of Legionnaire's pneumonia with respiratory failure, rhabdomyolysis and acute renal failure. Patient was a female, 61 yrs old, admitted to our hospital because of fever (38 degrees-38.5 degrees C), severe respiratory failure (pH = 7.49, PaCO2 = 23.1 mmHg, PaO2 = 56.7 mmHg), oliguria (< 200 ml/24 h); chest x-rays and computed tomography (TC) showed a pneumonia at right lower lobe. Among other things, in blood analysis was noted the following values: BUN = 47 mg/dl, creatinine = 2.1 mg/dl, Na+ = 133 mmol/L, Cl- = 97 mmol/L, Ca+ = 7.2 mg/dl, K+ = 5.8 mmol/L, AST = 213 U/L, ALT = 45 U/L, LDH = 1817 U/L, CPK = 16738 U/L, CPK-MB = 229 U/L, myoglobin > 4300 ng/ml., leucocyte count = 17,500/mmc (N = 92%, L = 3%, M = 5%), positive anti Legionella IgG and IgM (IgG > 1:64, IgM > 1:96), evidence of Legionella soluble antigen in the urine analysis. Therapy with clarytromicyne (500 mg b.i.d i.v.) and rifampicin (600 mg/die i.v.) was begun; computed tomography showed after six days an improvement of pulmonary lesion but, in the following days, health status and blood analysis got worse. Patient went on antibiotics and underwent haemotherapy (Hb: 8 gr/dl), haemodialysis because of acute renal failure but healthy status worse furthermore and she died on 18th days after admission. This case point out rhabdomyolysis with acute renal failure is suggestive for Legionnaire's disease and is associated with high rate of mortality.
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PMID:[Legionnaire's pneumonia with rhabdomyolysis and acute renal failure. A case report]. 1294 1

A 52-year-old man was admitted to our hospital because of fever and dyspnea. Chest X-ray film showed infiltrative shadows in the right lower lung fields and serum creatinine was 6.7 mg/dl. The patient was diagnosed as pneumonia complicated with acute renal failure. He was treated with antimicrobial therapy. However he developed respiratory failure and exhibited mental confusion. Legionnaires' disease was suspected, because pneumonia was found to be associated with multiple organ dysfunction. We started treatment with intravenous administration of minocycline and continuous hemodiafiltration and his condition had been rapidly improved. We diagnosed this case as legionnaires' disease due to the positive of urinary Legionella pneumophila serogroup 1 antigen. Since the cases of legionnaires' disease with acute renal failure are serious, prompt diagnosis and adequate treatment are essential.
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PMID:[A case of Legionnaires' disease with acute renal failure improved by continuous hemodiafiltration]. 1457 45

A 66-year-old man was admitted to our hospital with pyrexia up to 40 degrees C since one day after taking a public bath. Since multiple infiltrations on the lung were shown by chest radiography, severe pneumonia was diagnosed. Administration of antibiotics meropenem and erythromycin yielded no detected effect. Furthermore, rifampicin induced severe liver dysfunction. Improvement of clinical symptoms was seen after ciprofloxacine (CPFX) was given. Interstitial pneumonia, increases in KL-6 up to a level of 3545 U/ml and acute respiratory failure were improved by taking methylprednisolone. Since Legionella antigen was found in the urine, the use of CPFX was continued. Rhabdomyolysis and acute renal failure were successfully treated by transfusion, diuretic therapy, and glucocorticoid therapy. This was a very rare case of survival after Legionella pneumonia complicated with acute respiratory failure, acute renal failure, rhabdomyolysis, and interstitial pneumonia accompanied with a high KL-6 level, and successfully treated with steroids and CPFX.
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PMID:[Surviving case of Legionella pneumonia showing a high level of serum KL-6 and complicated with rhabdomyolysis]. 1545 47

A 77-year-old man who had fever and chest pain was admitted to a neighboring hospital on a diagnosis of pneumonia. Chest X-ray film finding deteriorated despite treatment with 2 g cefotaxime per day. Because of accompanying acute renal failure, he was transferred to our hospital. Hemodialysis with intravenous administration of erythromycin and meropenem resulted in recovery from acute renal failure, and his general condition improved. Because of liver dysfunction, erythromycin was changed to pazufloxacin. Although he was negative for Legionella urinary antigen determined with a rapid assay kit, Binax NOW, his serum titer for Legionella pneumophila serogroup 4 was elevated. Finally, a diagnosis of Legionnaires' disease caused by Legionella pneumophila serogroup 4 was established.
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PMID:[Legionnaires' disease with acute renal failure caused by Legionella pneumophilla serogroup 4]. 1636 67

Legionella pneumophila is a common cause of sporadic community-acquired pneumonia, but culture-proven legionellosis is rarely diagnosed. There is no laboratory test for Legionnaires' disease that can detect all patients with the disease. Culture is the standard diagnostic method and should be initiated as soon as possible in suspected cases. We describe a rare case of community-acquired pneumonia caused by L. pneumophila serogroup 6. A 77-year-old man was admitted to a tertiary care hospital because of high fever, productive cough, and progressive dyspnea. Chest radiography showed bilateral pneumonia, which led to respiratory failure necessitating mechanical ventilatory support. Despite antibiotic therapy, his condition continued to deteriorate and acute renal failure also developed. Urine was negative for L. pneumophila. Culture of the sputum yielded L. pneumophila serogroup 6, although there was no elevation of the serum antibody titer. Pneumonia resolved gradually and he was extubated after treatment with levofloxacin followed by erythromycin. L. pneumophila other than serogroup 1 should be included in the differential diagnosis of patients with suspected atypical community-acquired pneumonia.
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PMID:Severe community-acquired pneumonia due to Legionella pneumophila Serogroup 6. 1652 Aug 45

Legionella pneumophila infection is a recognized but rare cause of rhabdomyolysis. While the mechanism of rhabdomyolysis associated with Legionella is unknown, theories include direct invasion of Legionella into the muscle itself, or the release of its endotoxin into the circulation with subsequent muscle injury. In this case report, we describe a case of Legionella pneumonia presenting as altered mental status, high fever, and rhabdomyolysis with acute renal failure. We review the epidemiology, clinical and laboratory findings, and treatment of the disease.
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PMID:Legionella pneumonia presenting with rhabdomyolysis and acute renal failure: a case report. 1674 Apr 46

Legionnaires' disease (LD) is a systemic infectious disease primarily involving the lungs. Rhabdomyolysis, with subsequent acute renal failure, is an infrequently recognized entity associated with high mortality rates in LD patients. As in the case presented herein, initial respiratory signs and symptoms may not be prominent. Early diagnosis and appropriate treatment can be life-saving.
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PMID:Rhabdomyolysis-induced acute renal failure associated with legionnaires' disease. 1691 78

A 48-year-old man with diabetes mellitus and alcholic chronic pancreatitis was admitted to our hospital with fever and dyspnea. Chest x-ray film showed infiltration of the right upper lung field and blood exam demonstrated marked increase in CPK and renal dysfunction. Intravenous ceftriaxone sodium was started, but the next day, we started intravenous ciprofloxacin because the urine sample was positive for the Legionella antigen. Hemodialysis was started for acute renal failure due to rhabdomyolysis, and mechanical ventilation was introduced due to worsening of acute respiratory failure. Despite these treatments, bilateral infiltration on chest x-ray worsened, resulting in acute respiratory distress syndrome (ARDS). After administration of intravenous pulse methylpredonisolone and sivelestat (neutrophil elastase inhibitor), the patient was successfully weaned from mechanical ventilation. He was also removed from hemodialysis, and discharged from hospital with a good performance status 28 days later. The outcome in this case suggested that treatment with pulse steroid and sivelestat sodium in addition to antibiotics may be effective for Legionella pneumonia complicated by ARDS and acute renal failure.
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PMID:[A case of legionella pneumonia associated with acute respiratory distress syndrome (ARDS) and acute renal failure treated with methylprednisolone and sivelestat]. 1755 86


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