24 September 2023 : Case report
A Lethal Combination: Legionnaires’ Disease Complicated by Rhabdomyolysis, Acute Kidney Injury, and Non-Occlusive Mesenteric Ischemia
Unusual clinical course
Yuhei Fujisawa1ABCDEF*, Tatsuhito Miyanaga1E, Akari Takeji1E, Yukihiro Shirota 2E, Yoshimichi Ueda3EDOI: 10.12659/AJCR.940792
Am J Case Rep 2023; 24:e940792
Figure 4. Findings from the autopsy of the lung, kidney, and small and large intestines. (A) Lung showing massive consolidation in the right lower lobe (arrow). (B) Neutrophil cell infiltration within the alveoli observed in the right lower lobe (arrow). (C) Enlargement of the alveolar space and hyaline membrane formation in the upper right lobe (arrow). (D) Clear border between the pale renal cortex and the congestion in the medullary region (arrow). (E) Tubular epithelial cell desquamation and casts observed (arrow). (F) Immunohistological study using an anti-myoglobin antibody showing myoglobin casts in the distal tubules (arrow). (G) The entire lumen of the small and large intestines showing hemorrhagic necrosis. (H) The small intestine showing diffuse submucosal hemorrhage and nonobstructive mesenteric insufficiency (arrow).