[Surviving case of Legionella pneumonia showing a high level of serum KL-6 and complicated with rhabdomyolysis].

A 66-year-old man was admitted to our hospital with pyrexia up to 40 degrees C since one day after taking a public bath. Since multiple infiltrations on the lung were shown by chest radiography, severe pneumonia was diagnosed. Administration of antibiotics meropenem and erythromycin yielded no detected effect. Furthermore, rifampicin induced severe liver dysfunction. Improvement of clinical symptoms was seen after ciprofloxacine (CPFX) was given. Interstitial pneumonia, increases in KL-6 up to a level of 3545 U/ml and acute respiratory failure were improved by taking methylprednisolone. Since Legionella antigen was found in the urine, the use of CPFX was continued. Rhabdomyolysis and acute renal failure were successfully treated by transfusion, diuretic therapy, and glucocorticoid therapy. This was a very rare case of survival after Legionella pneumonia complicated with acute respiratory failure, acute renal failure, rhabdomyolysis, and interstitial pneumonia accompanied with a high KL-6 level, and successfully treated with steroids and CPFX.