- 期刊
Legionnaires' Disease and Rhabdomyolysis: A Case Report and Literature Review
退伍軍人病與橫紋肌溶解症：一個案例報告與文獻回顧
摘要
Legionnaires' disease, an important cause of severe community-acquired pneumonia, is usually suspected when patients present with extrapulmonary features along with the diagnosis of pneumonia. We describe a patient diagnosed with Legionnaires' disease due to the presence of a constellation of rare, characteristic extrapulmonary features, including rhabdomyolysis, relative bradycardia, elevated liver function and troponin I levels, hyponatremia, and mild hypokalemia. Given that Legionnaires' disease has been reported as the most common condition that causes rhabdomyolysis in patients diagnosed with bacterial pneumonia, preemptive levofloxacin was administered intravenously before the rapid urinary antigen test had confirmed the diagnosis. The patient made a full recovery. Based on the presentation of this case, we concluded that rhabdomyolysis that is otherwise unexplained in patients diagnosed with pneumonia should increase a suspicion of Legionnaires' disease.
並列摘要
退伍軍人病（Legionnaires' disease）是造成嚴重社區型肺炎（community-acquired pneumonia）的重要原因之一。患者經常只在被診斷肺炎時，同時表現出肺外特徵（extrapulmonary features）時才會被懷疑遭到此症感染。本文報告一位肺炎患者，因為同時出現一群少見且獨特之肺外特徵，包括橫紋肌溶解症（rhabdomyolysis）、相對性心搏過緩（relative bradycardia）、肝功能與肌鈣蛋白（troponin I）升高、低血鈉、輕微低血鉀，而被診斷患有退伍軍人病。基於過去文獻指出退伍軍人病為最常造成橫紋肌溶解症之細菌性肺炎，患者於快速尿液抗原確診退伍軍人病之前，便開始接受靜脈注射levofloxacin治療。患者最終亦完全康復。根據病人的臨床表現與本文中針對退與軍人病與橫紋肌溶解症之相關文獻回顧，我們建議當肺炎患者同時併有無法解釋之橫紋肌溶解症時，應該高度懷疑退伍軍人病的可能。