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Rhabdomyolysis of infectious and noninfectious causes
José Ramón Blanco1, Marta Zabalza, Javier Salcedo
1Servicio de Medicina Interna y Documentación Clínica Complejo Hospitalario Sán Millán-San Pedro, Lardero, Spain.
Background:
This study was done to determine variables associated with infectious rhabdomyolysis (IRM).
Methods:
In this retrospective case-control study, rhabdomyolysis (RM) was defined as a fivefold or greater elevation in creatine kinase (CK) levels with a muscle/brain (MB) fraction <5%. Patients with myocardial infarction or cerebrovascular accident or a recent history of surgery, trauma, or immobilization were excluded.
Results:
We analyzed 52 cases of RM seen at our institution between 1992 and 2000; IRM was the most frequent cause (31%), most commonly respiratory tract infections (38%). When a microorganism could be identified (50%), it was more often gram-negative (63%). Patients with IRM were elderly and had fever and lower CK levels. Infectious rhabdomyolysis was associated with a higher morbidity but not with a higher risk of death.
Conclusions:
Infectious rhabdomyolysis is the main cause of RM and must be suspected in elderly patients with fever and low levels of CK.
Insights
Infectious rhabdomyolysis is a common cause of rhabdomyolysis, particularly in elderly patients with fever and low creatine kinase levels. Prompt recognition of infectious rhabdomyolysis is crucial for managing this condition.
Area of Science:
- Medical Research
- Infectious Diseases
- Neurology
Background:
- Investigating factors linked to infectious rhabdomyolysis (IRM).
- Understanding the prevalence and characteristics of rhabdomyolysis (RM).
Purpose of the Study:
- To identify variables associated with infectious rhabdomyolysis.
- To characterize patients experiencing infectious rhabdomyolysis.
Main Methods:
- Retrospective case-control study.
- Defined rhabdomyolysis by creatine kinase (CK) elevation and low muscle/brain (MB) fraction.
- Excluded patients with myocardial infarction, cerebrovascular accident, or recent surgery, trauma, or immobilization.
Main Results:
- Infectious rhabdomyolysis was the most frequent cause of rhabdomyolysis (31%), often linked to respiratory tract infections (38%).
- Gram-negative bacteria were more frequently identified (63%) when microorganisms were detected.
- Patients with IRM were elderly, presented with fever, and had lower CK levels, indicating higher morbidity but not mortality.
Conclusions:
- Infectious rhabdomyolysis is the primary cause of rhabdomyolysis.
- Suspect infectious rhabdomyolysis in elderly patients presenting with fever and low CK levels.