Extremely elevated erythrocyte sedimentation rates (ESRs) in Legionnaires’ disease

Excerpt

Legionnaires’ disease is a common cause of non-zoonotic atypical community-acquired pneumonia (CAP). Like other atypical pneumonias, Legionnaires’ disease is a systemic infectious disease with characteristic extrapulmonary clinical and laboratory findings [1, 2]. Over the years, a variety of abnormal non-specific laboratory findings associated with Legionnaires’ disease have been described. Common non-specific test abnormalities with Legionnaires’ disease include mildly elevated serum transaminases, highly elevated creatine phosphokinase (CPK) levels, highly elevated serum ferritin levels, and microscopic hematuria [3]. Since the initial outbreak in Philadelphia, it has been known that erythrocyte sedimentation rates (ESRs) are elevated with Legionnaires’ disease [1, 2, 4]. The range of ESR elevations included in Legionnaires’ disease studies range from unelevated to extremely elevated, i.e., >100 mm/h. There has been no recent study specifically focused on ESR elevations in Legionnaires’ disease [4‐6]. …