Rhabdomyolysis of Infectious and Noninfectious Causes

Abstract

This study was done to determine variables associated with infectious rhabdomyolysis (IRM).In this retrospective case-control study, rhabdomyolysis (RM) was defined as a fivefold or greater elevation in creatine kinase (CK) levels with a muscle/brain (MB) fraction <5%. Patients with myocardial infarction or cerebrovascular accident or a recent history of surgery, trauma, or immobilization were excluded.We analyzed 52 cases of RM seen at our institution between 1992 and 2000; IRM was the most frequent cause (31%), most commonly respiratory tract infections (38%). When a microorganism could be identified (50%), it was more often gram-negative (63%). Patients with IRM were elderly and had fever and lower CK levels. Infectious rhabdomyolysis was associated with a higher morbidity but not with a higher risk of death.Infectious rhabdomyolysis is the main cause of RM and must be suspected in elderly patients with fever and low levels of CK.