Abstract Details

Title HyperCKemia in Patients with Legionella Infection

Topic Neuromuscular and Clinical Neurophysiology (EMG)

Presentation(s) Neuromuscular and Clinical Neurophysiology (EMG) Posters (7:00 AM-5:00 PM)

Poster/Presentation
Number 133

Objective We aim to establish the incidence, extent, and consequences of hyperCKemia in Legionella infection.

Background HyperCKemia in Legionella infection was previously described in case reports, but an association has not been established.

Design/Methods Our study included patients who had Legionella infection and underwent creatinine kinase (CK) testing at the time of infection in our single institution from 01/2010-12/2019. HyperCKemia was defined based on one of the following CK values: (1) exceeding normal range; (2) at least twice the highest baseline value if baseline CK was abnormal; or (3) ≥97.5 percentile as previously defined by Brewster et al. Data on demographics, co-morbidities, medications, symptoms, complications, and length of admission were collected.

Results A total of 267 patients with Legionella infection received CK testing during infection. The average age was 64 years, and 70% were male. No patients had a prior history of myopathy. Baseline CK was available in 192, and it exceeded 500 IU/L in one patient. During Legionella infection, hyperCKemia occurred in 144 (54%) of patients. The mean peak CK value was 9598 IU/L (range of 226 to 462,000). In 20 patients, peak CK value exceeded 10,000 IU/L. Myalgia was present in 13% and subjective weakness in 31%. When compared to patients without hyperCKemia, patients with hyperCKemia had prolonged hospital stay (11.1 versus 9.8 days), higher incidence of renal failure (60% versus 46%) and higher incidence of dialysis requirement (17% versus 6%). A total of 39 patients with hyperCKemia were evaluated by neurologists. No muscle biopsy or electromyography was performed.

Conclusions HyperCKemia is a frequent complication of Legionella infection. HyperCKemia can be prominent, leading to acute renal failure in need of hemodialysis, and resulting in prolonged hospital stay. Neurologists and neuromuscular physicians should be aware of the high incidence and possible severity of hyperCKemia in Legionella infection.

Authors/Disclosures
Jeremy Hill, MD (LeBauer Neurology) PRESENTER	Dr. Hill has nothing to disclose.
	No disclosure on file

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Abstract Details