Rhabdomyolysis and Influenza A (H3N2) infection--a case report/ Rabdomioliza i influenza a (H3N2) infekcija--prikaz slucaja

Citation metadata

Authors: Anja Stojsin, Vedrana Petric, Grozdana Canak, Vesna Turkulov, Sinisa Sevic and Maja Ruzic
Date: May-June 2017
From: Medicinski Pregled(Vol. 70, Issue 5-6)
Publisher: Drustvo Lekara Vojvodine
Document Type: Case study
Length: 2,278 words

Main content

Abstract :

Introduction. Extrapulmonary complications of influenza infections are often unrecognized. The aim of this paper is to point to rhabdomyolysis as a potentially life threatening complication of influenza. Case Report. A month after the onset of influenza complicated by bronchopneumonia, the general condition of a nineteen year old female deteriorated with development of progressive muscle weakness and dark-colored urine. Despite intensive hydration and antibiotic therapy, her condition got worse, laboratory findings showed pancytopenia, hypoalbuminemia and creatine phosphokinase about 1000 times higher than normal. Influenza A H3N2 was confirmed by polymerase chain reaction analysis of the throat swab sample. Electromyoneurography showed severe acute polyneuropathy of muscles innervated by perineal nerve and signs of polymyositis; pathohistological examination of gastrocnemius muscle biopsy sample confirmed chronic myositis with necrotic neurogenic atrophy. In spite of intense hydration, the patient's status continued deteriorating, so methylprednisolone was administered. Six weeks later, the patient was discharged in a good general condition, with blood test results within reference ranges, with weakness of foot dorsiflexors and tilting of the pelvis to the left during verticalization. Conclusion. Rhabdomyolysis caused by influenza-A is on the increase, and given the degree of morbidity and mortality, thorough assessment of patients is necessary. Key words: Rhabdomyolysis; Influenza A Virus, H3N2 Subtype; Polyneuropathies; Risk Factors; Signs and Symptoms; Disease Progression; Treatment Outcome Uvod. Ekstrapulmonalne komplikacije influenca virusne infekcije su cesto neprepoznate. Cilj ovog rada je da se ukaze na rabdomiolizu kao potencijalnu vitalno ugrozavajucu komplikaciju gripa. Prikaz slucaja. Mesec dana nakon pocetka gripa komlikovane bronhopneumonijom, kod devetnaestogodisnje devojke doslo je do pogorsanja opsteg stanja razvojem progresivne misicne slabosti, uz pojavu tamne prebojenosti urina. Na sprovedenu intenzivnu rehidrataciju i antibiotsku terapiju, opste stanje se i dalje pogorsava, a u laboratorijskim nalazima se zapaza pancitopenija, hipoalbuminemija i oko 1 000 puta povisena aktivnost kreatin fosfokinaze. Analizom polimerazne lancane reakcije uzorka brisa grla dokazana je Influenza A H3N2. Elektromioneurografijom se verifikuje akutna teska polineuropatija muskulature koju inervise n. peroneus i znaci polimiozitisa, a patohistoloski pregled bioptata levog m. gastrocnemius potvrduje myositis chronica cum atrophia neurogenes cum necrosis. Kako i pored obilne hidratacije nije doslo do ocekivanog poboljasnja stanja bolesnice, ordiniran je metilprednizolon. Nakon sest nedelja lecenja, pacijentkinja je otpustena dobrog opsteg stanja, urednih laboratorijskih nalaza, sa slaboscu dorzifleksora stopala i naginjanjem karlice na levu stranu tokom vertikalizacije. Zakljucak. Rabdomioliza uzrokovani influencom-A se sve cesce belezi u praksi, a s obzirom na stepen morbiditeta i mortaliteta iziskuje pazljiv pristup proceni stanja pacijenta. Kljucne reci: rabdomioliza; influenca A virus, podtip H3N2; polineuropatije; faktori rizika; znaci i simptomi; progresija bolesti; ishod lecenja

Source Citation

Source Citation
Stojsin, Anja, et al. "Rhabdomyolysis and Influenza A (H3N2) infection--a case report/ Rabdomioliza i influenza a (H3N2) infekcija--prikaz slucaja." Medicinski Pregled, vol. 70, no. 5-6, 2017, p. 173+. Accessed 3 Dec. 2020.
  

Gale Document Number: GALE|A503775541