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Updated: May 3, 2026

Induction and Assessment of Exertional Skeletal Muscle Damage in Humans
Published on: December 11, 2016
Rash and elevated creatine kinase in a deployed soldier
Thomas W Schmidt1, Mark Garfinkle2, Daniel F Battafarano1
1Department of Rheumatology, Brooke Army Medical Center, 3551 Roger Brooke Drive, Fort Sam Houston, TX 78234-6272.
Abstract:
A 24-year-old active duty soldier was evacuated from Afghanistan to the United States after persistent upper respiratory tract infection. His course was complicated by an exfoliative rash, diffuse muscle aches, and elevated creatine kinase following trimethoprim-sulfamethoxazole exposure that persisted despite withdrawal of the medication. Dermatomyositis was strongly considered, but the patient had a negative muscle biopsy and had positive serologies for acute Epstein-Barr virus infection. We present a case of acute Epstein-Barr virus infection and possible trimethoprim-sulfamethoxazole reaction mimicking dermatomyositis.
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