[More than muscle stiffness]

Area of Science:

• Pediatrics
• Infectious Diseases
• Nephrology

Background:

• Respiratory Syncytial Virus (RSV) is a common cause of lower respiratory tract infections in infants.
• Bronchiolitis, an inflammation of the small airways, is a frequent manifestation of RSV infection.
• Rhabdomyolysis, the breakdown of muscle tissue, can occur as a complication of various illnesses.

Observation:

• A four-month-old infant with RSV bronchiolitis developed rhabdomyolysis.
• The rhabdomyolysis was likely multifactorial, including hyperthermia, dehydration, hypernatremia, and metabolic acidosis.
• Severe complications arose, such as acute renal failure, hepatic dysfunction, and disseminated intravascular coagulation.

Findings:

• Rhabdomyolysis in infants can present with varied symptoms, often lacking the classic triad of muscle pain, weakness, and dark urine.
• Multifactorial rhabdomyolysis in this case led to significant organ dysfunction.
• Complete recovery was achieved with adequate fluid resuscitation.

Implications:

• Early recognition and management of rhabdomyolysis complications are vital in pediatric critical care.
• Sufficient fluid supply is the primary therapeutic strategy for rhabdomyolysis, especially in the context of dehydration and electrolyte imbalances.
• Understanding the link between viral infections like RSV and rhabdomyolysis can inform clinical practice and potentially improve patient outcomes.