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Rhabdomyolysis and Acute Kidney Injury Associated with Salmonella Infection: A Report of 2 Cases

In Hee Lee1, Dong Jik Ahn2

  • 1Department of Internal Medicine, Daegu Catholic University School of Medicine, Daegu, South Korea.

The American Journal of Case Reports
|June 8, 2022
PubMed

Insights

Nontyphoidal Salmonella infection can rarely cause acute gastroenteritis complicated by rhabdomyolysis and acute kidney injury. Prompt antibiotic and fluid therapy, and early hemodialysis, improve patient outcomes.

Area of Science:

  • Nephrology
  • Infectious Diseases
  • Gastroenterology

Background:

  • Rhabdomyolysis is a syndrome of muscle breakdown with elevated creatine kinase (CK) and myoglobin.
  • While diverse causes exist, Salmonella infection is a rare but documented etiology.
  • This report details two cases of nontyphoidal Salmonella gastroenteritis complicated by rhabdomyolysis and myoglobinuric acute kidney injury (AKI).

Observation:

  • Two male patients presented with acute gastroenteritis symptoms, including fever, abdominal pain, and diarrhea.
  • Both exhibited significantly elevated serum CK and creatinine levels, alongside high myoglobin concentrations and myoglobinuria.
  • Blood cultures identified Salmonella B and Salmonella C in the respective cases.

Findings:

  • Both patients received fluid therapy and empirical intravenous antibiotics.
  • One patient required hemodialysis due to persistent oliguria and metabolic acidosis.
  • Clinical symptoms improved in both cases after approximately two weeks of inpatient care.

Implications:

  • Salmonella gastroenteritis can, in rare instances, lead to rhabdomyolysis and myoglobinuric AKI.
  • Timely antibiotic and fluid administration is crucial for favorable prognosis.
  • Early hemodialysis initiation can significantly improve clinical outcomes in patients with oliguric AKI.

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