title: Severe Legionnaires' Disease Complicated by Rhabdomyolysis and Clinically Resistant to Moxifloxacin in a Splenectomised Patient: Too Much of a Coincidence?
abstract: We here report a case of Legionnaires' disease in a splenectomised patient, complicated by rhabdomyolysis and acute renal failure and characterized by a poor clinical response to moxifloxacin. Splenectomy is not included among the factors, typically associated with higher risk or mortality in patients with Legionellosis. However, our report is consistent with previous case reports describing severe Legionella infections in asplenic subjects. The possibility that functional or anatomic asplenia may be a factor predisposing to severe clinical course or poor response to therapy in patients with Legionella infection cannot be excluded, deserving further investigation in the future. More studies are required in order to clarify the underlying pathophysiological mechanisms that connect asplenia, immunological response to Legionella, and pathogen's resistance to antibiotics.
authors.affiliation: Department of Internal Medicine, General Hospital of Larissa, 1 Tsakalof Street, 41221 Larissa, Greece.
authors.forename: Theocharis
authors.initials: T
authors.lastname: Koufakis
authors.affiliation: Department of Internal Medicine, General Hospital of Larissa, 1 Tsakalof Street, 41221 Larissa, Greece.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Gabranis
authors.affiliation: Department of Microbiology, General Hospital of Larissa, 41221 Larissa, Greece.
authors.forename: Marianneta
authors.initials: M
authors.lastname: Chatzopoulou
authors.affiliation: Department of Internal Medicine, General Hospital of Larissa, 1 Tsakalof Street, 41221 Larissa, Greece.
authors.forename: Anastasios
authors.initials: A
authors.lastname: Margaritis
authors.affiliation: Department of Microbiology, General Hospital of Larissa, 41221 Larissa, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Tsiakalou