Exertional rhabdomyolysis in an adolescent athlete

Exertional rhabdomyolysis has been previously reported in adult patients following such strenuous activities as military basic training, weight lifting, and marathon running. Exertional rhabdomyolysis in previously healthy pediatric athletes, however, is rarely encountered. The presentation of rhabdomyolysis is characterized by the classical triad of myalgias, muscle weakness, and darkened urine. This classic presentation, however, is not noted the majority of patients, especially early in the disease course when the patient may complain only of myalgias or weakness. Thus, the emergency physician must have a high index of suspicion for this entity based on the appropriate clinical setting. We report a classic case of exercise-induced rhabdomyolysis complicated by acute renal failure in a previously healthy adolescent athlete, whose initial presentation was nonspecific, prompting the diagnosis of overexertion.