ABSTRACT

Patients with Legionnaires' disease typically have anorexia, myalgia, nonproductive cough, recurrent chills, fever, shortness of breath, and pleuritic pain. Although most patients with Legionnaires' disease have abnormal liver function tests, the necropsy does not reveal specific abnormalities to correlate with the clinical presentation. Patients with Legionnaires' disease may develop renal insufficiency, and urinalysis may reveal proteinuria, hematuria, and casts. Despite these clinical presentations, morphological studies of those available kidneys from Legionnaires' disease patients have not revealed definite characteristic abnormalities. A. W. Lees and W. F. Tyrrell reported two cases of Legionnaires' disease associated with severe cerebral disturbances. One exhibited aphasia, extensor plantar response, and ataxia. The other exhibited disturbances of sensation and isolated grip and limb weakness, suggesting the occurrence of a cerebrovascular accident or other brain lesions. Adrenal glands are usually normal in guinea pigs infected with Legionnaires' disease bacteria. Rarely, one may exhibit foci of acute inflammation, microabscesses, and/or scattered neutrophils among parenchymal cells of the zona fasciculata.