Acquired Fanconi Syndrome in the Setting of Legionella Pneumonia
Abstract
Abstract INTRODUCTION: Legionella pneumonia, caused by Legionella pneumophila, is a well-known cause of community-acquired pneumonia. The respiratory manifestations of Legionella infections are well documented; however, extra-pulmonary complications are less frequently reported in the literature. This case report highlights a rare case of a patient with Legionella pneumonia who developed Fanconi syndrome, a renal disorder characterized by proximal tubular dysfunction.CASE DESCRIPTION: A 58-year-old woman with a past medical history of chronic bronchitis presented with complaints of worsening shortness of breath, pleuritic chest pain, productive cough, and fever for the past two days. On examination, she was febrile and hypoxic requiring 2 liters of oxygen by nasal cannula. Rhonchi were heard on auscultation of the left lung field. Laboratory findings revealed elevated white blood cell count, hyponatremia, hypokalemia, and a non-anion-gap metabolic acidosis. Urinalysis showed ketonuria, proteinuria, and a high urine-specific gravity. Chest imaging revealed a consolidation in the left mid to lower lung consistent with pneumonia. Community-acquired pneumonia was diagnosed, and empirical antibiotics (ceftriaxone and azithromycin) were started. Urinary Legionella antigen testing was positive, confirming Legionella pneumophila infection. The patient was subsequently treated with levofloxacin. Her electrolyte abnormalities and symptoms improved significantly within the next 48…
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Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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