Acute pancreatitis caused by severe Legionella pneumophila infection

We report three cases of severe community-acquired Legionella pneumophila p neumonia with acute pancreatitis. Pancreas involvement is unusual. The clin ical presentations consisted of painless pancreatitis with only elevation o f serum pancreatic enzymes (case 1), tender abdomen with edematous pancreas on computed tomography scan (case 2) and necrosis (case 3). We discuss the possible mechanisms of L. pneumophila associated acute pancreatitis for wh ich the pathophysiology is still undetermined: infection, toxin release or cytokine secretion.