Rhabdomyolysis induced by Pseudomonas aeruginosa sepsis

We describe advanced hemodynamic insufficiency and remarkably high myoglobinemia in a 77-year-old man who was admitted to the intensive care unit after total aortic arch replacement. Serum myoglobin showed an unusually high value (peak value, 155,030 ng x ml(-1)). The patient died of sepsis and untreatable metabolic acidosis. Pseudomonas aeruginosa was detected in blood culture specimens after his death. On histopathological examination, dense congregations of gram-negative bacilli were present in clots in blood vessels, while congregations of gram-negative bacilli around the circumference of small blood vessels were particularly apparent in every specimen examined. Moreover, a generalized breakdown of muscle fibers, consistent with findings of rhabdomyolysis, was observed in muscle tissue throughout the body.