31 January 2025
: Case report 
Rhabdomyolysis of Infectious Etiology with Creatine Kinase Above One Million: A Case Report
Unusual clinical course, Challenging differential diagnosis
Marshall Weber ABCDEF 1,2, William Goss BCDE 1, Colton Hoffer BCDEF 2,3, Joseph Ogunsulire CDEG 4, Ferdinand Schafer ADE 1*DOI: 10.12659/AJCR.946364
Am J Case Rep 2025; 26:e946364
Table 2. Etiologies of rhabdomyolysis.
| Crush syndrome, motor vehicle collisions, burns [,]1 |
| Falls with prolonged immobility, prolonged surgery without positional change []7 |
| Shock, sepsis, hypothermia, embolism or thrombosis of major artery, arterial clamping during surgery []7 |
| Strenuous exercise, seizures, alcohol withdrawal, status asthmaticus, tetanus [,]6 |
| High-voltage electrical injury, lightning strike []7 |
| Carbon monoxide poisoning, cyanide poisoning [], ethylene glycol, isopropyl alcohol [], metals (barium [], copper []), supplements (Licorice (), Ephedra sinica) [], environmental toxins (water hemlock ingestion ( spp. or spp.) [], mushroom ingestion (, , , spp., spp.)) [], insect envenomation, snake envenomation [], Haff disease [], diquat []6 |
| Malignant hyperthermia, neuroleptic malignant syndrome, heat stroke []6 |
| Influenza A and B, coxsackie virus A and B, Epstein-Barr virus, COVID-19, herpes simplex virus (HSV) 1 and 2, parainfluenza virus, adenovirus, enterovirus, Cytomegalovirus (CMV), varicella zoster virus (VZV), primary human immunodeficiency virus (HIV), , spp., spp. [], Chikungunya virus [], [], spp., spp., spp., , spp., Tularemia (), spp., spp., spp., spp., , , []16 |
| Hypokalemia, hypophosphatemia, hypocalcemia []6 |
| Polymyositis, dermatomyositis []6 |
| Hyperaldosteronism, hypothyroidism, diabetic ketoacidosis, hyperosmolar hyperglycemic state []6 |
| Antipsychotics (eg, haloperidol, chlorpromazine, promethazine), antidepressants (eg, amitriptyline, doxepin, fluoxetine, lithium), sedative hypnotics (eg, benzodiazepines, barbiturates), lipid-lowering agents (eg, statins, fibrates), antihistamines (eg, diphenhydramine, doxylamine), drug abuse (eg, alcohol, heroin, cocaine, amphetamines, D-lysergic acid diethylamide [LSD]), others (eg, amphotericin B, azathioprine, acetaminophen, salicylates, succinylcholine, thiazides, vasopressin) []7 |
| Glycogen storage diseases, such as deficiencies of myophosphorylase (GSD V or McArdle disease), phosphofructokinase (GSD VII), phosphorylase kinase (GSD VIII), phosphoglycerate kinase (GSD IX), phosphoglycerate mutase (GSD X), and lactate dehydrogenase (GSD XI). Lipid metabolism disorders, such as deficiencies of carnitine palmitoyl transferase II, long-chain acyl-CoA dehydrogenase, very-long-chain acyl-CoA dehydrogenase, medium-chain acyl-CoA dehydrogenase, short-chain L-3-hydroxyacetyl CoA dehydrogenase, medium-chain L-3-hydroxyacetyl CoA, thiolase). Mitochondrial disorders, such as deficiencies of succinate dehydrogenase, cytochrome c oxidase, coenzyme Q10), glucose-6-phosphate dehydrogenase deficiency, myoadenylate deaminase deficiency, and sickle-cell trait []1 |