Rhabdomyolysis secondary to influenza virus infection
DOI:
https://doi.org/10.5935/2764-734X.e20240139Keywords:
Influenza Human, Rhabdomyolysis, Influenza A Virus, H1N1 Subtype, Creatine Kinase, Case ReportAbstract
Rhabdomyolysis is a potentially serious condition that may result from influenza infection. We report the case of a 32-year-old man with no comorbidities who presented with fever, myalgia, and dark urine that had been developing for 4 days, followed by cough and runny nose. The tests showed a significant increase in creatine phosphokinase (64,617 U/L) and transaminases. Before specific confirmation of Influenza A and B infection, the main diagnostic hypotheses to justify the condition were infectious etiology, particularly leptospirosis and acute viral hepatitis. Apart from ceftriaxone medication for 10 days, the patient received early vigorous intravenous hydration that contributed to favorable progression of the clinical presentation and laboratory results and to the absence of kidney damage.
References
1. Torres PA, Helmstetter JA, Kaye AM, Kaye AD. Rhabdomyolysis: pathogenesis, diagnosis, and treatment. Ochsner J. 2015;15(1):58-69. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4365849/
2. Fadila MF, Wool KJ. Rhabdomyolysis secondary to influenza a infection: a case report and review of the literature. N Am J Med Sci. 2015;7(3):122-4. DOI: https://doi.org/10.4103/1947-2714.153926
3. Singh U, Scheld WM. Infectious etiologies of rhabdomyolysis: three case reports and review. Clin Infect Dis. 1996;22(4):642-9. DOI: 10.1093/clinids/22.4.642
4. Paules C, Subbarao K. Influenza. Lancet. 2017;390(10095):697-708. DOI: 10.1016/S0140-6736(17)30129-0
5. Krammer F, Smith GJD, Fouchier RAM, Peiris M, Kedzierska K, Doherty PC, et al. Influenza. Nat Rev Dis Primers. 2018;4(1):3. DOI: 10.1038/s41572-018-0002-y
6. Almeida ARM. Dinâmica sazonal da influenza no Brasil: a importância da latitude e do clima [Tese na Internet]. Rio de Janeiro: Escola Nacional de Saúde Pública Sergio Arouca (ENSP)/Fundação Oswaldo Cruz (FIOCRUZ); 2018; [acesso em 2023 Out 10]. Disponível em: https://www.arca.fiocruz.br/bitstream/handle/icict/34080/ve_Alexandra_Ribeiro_ENSP_2018?sequence=2&isAllowed=y
7. Ministério da Saúde (BR). Secretaria de Vigilância em Saúde. Departamento de Vigilância em Saúde e Ambiente. Informe Técnico Operacional: Vacinação contra a Influenza [Internet]. 1ª ed. Brasília: Ministério da Saúde; 2023; [acesso em 2024 Jan 31]. Disponível em: https://www.gov.br/saude/pt-br/assuntos/saude-de-a-a-z/c/cale8ndario-nacional-de-vacinacao/arquivos/informe-tecnico-operacional-de-vacinacao-contra-a-influenza-2023
8. Nicholls JM, Chan RW, Russell RJ, Air GM, Peiris JS. Evolving complexities of influenza virus and its receptors. Trends Microbiol. 2008;16(4):149-57. DOI: 10.1016/j.tim.2008.01.008
9. Desdouits M, Munier S, Prevost MC, Jeannin P, Butler-Browne G, Ozden S, et al. Productive infection of human skeletal muscle cells by pandemic and seasonal influenza A(H1N1) viruses. PLoS One. 2013;8(11):e79628. DOI: 10.1371/journal.pone.0079628
10. Tanaka T, Takada T, Takagi D, Takeyama N, Kitazawa Y. Acute renal failure due to rhabdomyolysis associated with echovirus 9 infection: a case report and review of literature. Jpn J Med. 1989;28(2):237-42. DOI: 10.2169/internalmedicine1962.28.237
11. Perez-Padilla R, de la Rosa-Zamboni D, Ponce de Leon S, Hernandez M, Quiñones-Falconi F, Bautista E, et al. Pneumonia and respiratory failure from swine-origin influenza A (H1N1) in Mexico. N Engl J Med. 2009;361(7):680-9. DOI: 10.1056/NEJMoa0904252
12. Borgatta B, Pérez M, Rello J, Vidaur L, Lorente L, Socías L, et al. Elevation of creatine kinase is associated with worse outcomes in 2009 pH1N1 influenza A infection. Intensive Care Med. 2012;38(7):1152-61. DOI: 10.1007/s00134-012-2565-5
13. Runnstrom M, Ebied AM, Khoury AP, Reddy R. Influenza-induced rhabdomyolysis. BMJ Case Rep. 2018;11(1):e226610. DOI: 10.1136/bcr-2018-226610
14. Sato E, Nakamura T, Koide H. Rhabdomyolysis induced by influenza A infection: case report and review of literature. Ther Apher Dial. 2011;15(2):208-9. DOI: 10.1111/j.1744-9987.2010.00900.x
15. Lai CC, Wang CY, Lin HI. Rhabdomyolysis and acute kidney injury associated with 2009 pandemic influenza A(H1N1). Am J Kidney Dis. 2010;55(3):615. DOI: 10.1053/j.ajkd.2010.01.002
16. Uyeki TM, Bernstein HH, Bradley JS, Englund JA, File TM, Fry AM, et al. clinical practice guidelines by the Infectious Diseases Society of America: 2018 update on diagnosis, treatment, chemoprophylaxis, and institutional outbreak management of seasonal Influenza. Clin Infect Dis. 2019;68(6):895-902. DOI: 10.1093/cid/ciy874
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Infections in Evidence

This work is licensed under a Creative Commons Attribution 4.0 International License.
The Copyright Transfer Agreement also understands that the authors guarantee that the respective Case Report has never been published in another communication vehicle or scientific journal. Papers presented at meetings and/or scientific congresses may be published in the electronic journal INFECTIOUS DISEASES IN EVIDENCE - Case Reports, provided that they have not been published in whole or in part in their Proceedings or Annals.