High Creatine Kinase Levels in Viral Myositis: A Case of Rhabdomyolysis-Induced Renal Failure

Abstract

Patient: Male, 47-year-old

Final Diagnosis: Viral myositis complicated by rhabdomyolysis and acute kidney injury Symptoms: Anorexia • flu-like symptoms • generalized muscle aches

Clinical Procedure: —

Specialty: Infectious Diseases • General and Internal Medicine • Nephrology

Objective:

Unusual clinical course

Background:

Viral infections can cause a spectrum of muscle involvement, from mild myalgia to severe conditions like rhabdomyolysis. While benign muscle pain is common, viral myositis complicated by rhabdomyolysis and acute kidney injury is an uncommon but serious occurrence. If not promptly recognized and treated, these complications can result in significant morbidity and even mortality. Timely diagnosis and intervention are crucial to mitigating the risks.

Case Report:

We present the case of a 47-year-old man with a history of recent flu-like symptoms, who developed generalized muscle pain and weakness. Upon further evaluation, he was diagnosed with acute viral myositis. His condition was complicated by severe rhabdomyolysis, as evidenced by a markedly elevated creatine phosphokinase (CPK) level of 880 300 U/L, which subsequently led to acute kidney injury. Despite immediate intervention with aggressive intravenous fluid resuscitation, he required emergency hemodialysis secondary to electrolyte imbalances. Over the course of several weeks, he required ongoing dialysis, but with continued treatment his renal function gradually improved, and dialysis was discontinued after 1 month.

Conclusions:

This case highlights the importance of early recognition and treatment of viral myositis complicated by rhabdomyolysis and acute renal failure. Aggressive management, including fluid resuscitation and hemodialysis, is crucial in preventing life-threatening complications.