Riou B, Richard C, Teboul J L, Rimailho A, Auzépy P
Rev Med Interne. 1985 Mar;6(2):105-10. doi: 10.1016/s0248-8663(85)80053-9.
Two cases of Legionnaires' disease proven by seroconversion in indirect immunofluorescence are reported. Creatine phosphokinase (CPK) was increased in both patients, and one had rhabdomyolysis with acute renal failure and acute respiratory distress. A review of the literature brought out 9 other cases of rhabdomyolysis associated with Legionnaires' disease. Myalgias are an inconstant warning symptom; renal impairment is present in more than one half of the cases, and although pulmonary lesions are moderate, respiratory muscle involvement may require mechanical ventilation. In view of the severe complications of rhabdomyolysis, CPK should be systematically assayed in patients with Legionnaires' disease; 57 p. 100 of whom, according to published reports, have high CPK levels. In a retrospective study of bacterial pneumonia caused by common pathogens, we found that CPK was elevated in 31 p. 100 of the cases. The mechanism of muscular involvement is discussed.
报告了两例经间接免疫荧光法血清学转换证实的军团病病例。两名患者的肌酸磷酸激酶（CPK）均升高，其中一名患者发生横纹肌溶解，并伴有急性肾衰竭和急性呼吸窘迫。文献回顾发现了另外9例与军团病相关的横纹肌溶解病例。肌痛是一种不恒定的警示症状；超过一半的病例存在肾功能损害，尽管肺部病变较轻，但呼吸肌受累可能需要机械通气。鉴于横纹肌溶解的严重并发症，对于军团病患者应系统检测CPK；根据已发表的报告，其中57%的患者CPK水平较高。在一项对常见病原体引起的细菌性肺炎的回顾性研究中，我们发现31%的病例CPK升高。文中讨论了肌肉受累的机制。
