Myositis and acute kidney injury in bacterial atypical pneumonia: Systematic literature review

Chiara Simoni, Pietro Camozzi, Pietro B. Faré, Mario G. Bianchetti, Lisa Kottanattu, Sebastiano A.G. Lava, Gregorio P. Milani

Research output: Contribution to journalArticlepeer-review


Background: Bacterial community-acquired atypical pneumonia is sometimes complicated by a myositis or by a renal parenchymal disease. Available reviews do not mention the concurrent occurrence of both myositis and acute kidney injury. Methods: In order to characterize the link between bacterial community-acquired atypical pneumonia and both myositis and a renal parenchymal disease, we reviewed the literature (United States National Library of Medicine and Excerpta Medica databases). Results: We identified 42 previously healthy subjects (35 males and 7 females aged from 2 to 76, median 42 years) with a bacterial atypical pneumonia associated both with myositis (muscle pain and creatine kinase ≥5 times the upper limit of normal) and acute kidney injury (increase in creatinine to ≥1.5 times baseline or increase by ≥27 μmol/L above the upper limit of normal). Thirty-six cases were caused by Legionella species (N = 27) and by Mycoplasma pneumoniae (N = 9). Further germs accounted for the remaining 6 cases. The vast majority of cases (N = 36) presented a diffuse myalgia. Only a minority of cases (N = 3) were affected by a calf myositis. The diagnosis of rhabdomyolysis-associated kidney injury was retained in 37 and that of acute interstitial nephritis in the remaining 5 cases. Conclusion: Bacterial atypical pneumonia may occasionally induce myositis and secondary kidney damage.

Original languageEnglish
Pages (from-to)2020-2024
Number of pages5
JournalJournal of Infection and Public Health
Issue number12
Publication statusPublished - Dec 2020


  • Acute kidney injury
  • Acute renal failure
  • Chlamydia
  • Mycoplasma
  • Rhabdomyolysis

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

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