Legionella pneumophila pneumonia complicated by acute hemorrhagic leukoencephalopathy (AHLE) and rhabdomyolysis is an extremely rare clinical entity. This report presents the case of a female patient diagnosed with Legionella pneumophila pneumonia who subsequently developed AHLE and rhabdomyolysis. Laboratory investigations demonstrated markedly elevated creatine kinase and myoglobin levels, and a head CT scan revealed multiple cerebral hemorrhagic lesions. The patient received a multidisciplinary treatment regimen, including anti-infective therapy, respiratory support, fluid resuscitation, blood purification, neuroprotective measures, corticosteroids, immunoglobulin therapy, and symptomatic supportive care. The patient's condition gradually improved, and she was successfully discharged. This case highlights the need for clinicians to remain vigilant for rare but severe complications associated with Legionella infections and emphasizes the importance of timely, comprehensive management in achieving favorable outcomes.
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