Acute Pancreatitis Caused by Legionella pneumophila

Acute Pancreatitis Caused by Severe Legionella pneumophila Infection

“…pneumophila infection was multisystemic in our three patients with hypoxemic pneumonia, acute renal failure, rhabdomyolysis and mental confusion. Acute renal failure occurred in each of our cases, however pancreatitis may occur in its absence [4,6,8].Anti-Legionella therapy in severe presentations consists of iv macrolides, quinolones or one of the two in association with rifampicin.These antibiotics, with excellent intracellular and tissue penetration properties, were appropriate in these cases of associated pancreatitis.…”

“…The three cases presented here are proven cases of L. pneumophila infection. In each case L. pneumophila was isolated in sputum culture during severe pneumonia with a corresponding significant rise in antibody titer, ruling out any cross-reaction in immunofluorescence tests [4,9]. Pancreatitis was confirmed by X-ray findings and by increases in serum lipase, eliminating the usual difficulties in assessing serum amylase in acute renal failure patients [4,10].…”

“…Pancreatitis appears to be generally concurrent with primary pneumonia [3][4][5][6][7][8][9][10].As in the case of our first patient, pancreatitis may be painless and revealed only by elevated serum amylase or lipase with possible CTscan enlargement of the pancreas [3][4][5]8]. In contrast, as seen in case 3, it may represent a serious illness leading to necrotizing and hemorrhagic pancreatitis [7] or pancreatic cysts [6].…”

“…However, it is difficult to determine definitively whether other factors, especially alcohol or possible pancreatic duct obstruction by sludge, may have played a part in the associated pancreatitis [4].…”

“…Legionella is a rare infectious cause of pancreatitis with unknown incidence [2]. To date, less than ten cases have been reported [3][4][5][6][7][8][9][10]. In this report, we present three cases of pancreatitis among 14 successive patients hospitalized in our intensive care unit (ICU) for community-acquired severe Legionnaires' disease, identified by retrospective review over an 8 year period.…”