A Lethal Combination: Legionnaires’ Disease Complicated by Rhabdomyolysis, Acute Kidney Injury, and Non-Occlusive Mesenteric Ischemia

24 September 2023 : Case report Japan

Unusual clinical course

Yuhei Fujisawa^1ABCDEF*, Tatsuhito Miyanaga^1E, Akari Takeji^1E, Yukihiro Shirota

^2E, Yoshimichi Ueda^3E

DOI: 10.12659/AJCR.940792

Am J Case Rep 2023; 24:e940792

Table 1. Laboratory data of patients on admission.

			Normal range				Normal range

Protein	3+		–	TP	6.9	g/dL	6.5–8.2
Occult blood	3+		–	Alb	3.6	g/dL	3.7–5.5
RBC	>100	/HPF	1–4	T-Bil	1.36	mg/dL	0.30–1.20
				AST	797	U/L	10–40
				ALT	211	U/L	5–45
pH	7.352		7.35–7.45	ALP (JSCC)	242	U/L	104–338
PaCO	27.2	mmHg	35–45	LDH	2900	U/L	120–245
PaO	61.3	mmHg	80–100	γ-GTP	75	U/L	0–79
HCO	14.7	mEq/L	22–26	CK	100,266	U/L	38–196
Lac	3.3	mmol/L	0.59–1.39	Na	139	mEq/L	135–145
				K	4.2	mEq/L	3.5–5.0
				Cl	103	mEq/L	98–108
WBC	32,430	/μL	3,500–9,000	Ca	8.3	mg/dL	8.2–10.0
Neu	91.2	%	42.0–74.0	P	4.4	mg/dL	2.5–4.5
Hb	17.0	g/dL	11.2–15.2	Cr	2.61	mg/dL	0.46–0.82
Plt	21.0	×10/μL	14.0–37.9	eGFR	20.0	ml/min/1.73 m
				HbA1c	5.7	%	4.6–6.2
				BNP	243	pg/mL	0.0–18.4
PT	62.6	%	80.0–120.0	Ferritin	12,902	ng/dL	5–157
aPTT	35	sec	26.0–38.0	CRP	35.8	mg/dL	0.00–0.30
D-dimer	3.2	μg/mL
^* 10 L/min of supplemental oxygen via reservoir mask ABG – arterial blood gas; PT – prothrombin time; aPTT – activated partial thromboplastin time; TP – total protein; Alb – albumin; T-Bil – total bilirubin; AST – aspartate aminotransferase; ALT – alanine transaminase; LDH – lactate dehydrogenase; γ-GTP – gamma-glutamyl transpeptidase; CK – creatine kinase; eGFR – estimated glomerular filtration rate; BNP – B-type natriuretic peptide; CRP – C-reactive protein.