Non-hemorrhagic dengue fever with rhabdomyolysis

Abstract

Acute kidney injury occurs in 33-50% of patients with rhabdomyolysis and infections remain one of the major contributing factors. The incidence of rhabdomyolysis in non-hemorrhagic dengue virus infection is quite low and may go unnoticed, especially if the presentation is not florid. We report a case of a young male patient, sero-positive for dengue, with no hemorrhagic manifestations or hypotension, who developed rhabdomyolysis complicated by renal failure. The patient eventually needed dialysis support and later recovered fully. Clinicians need to be aware of the occurrence of rhabdomyolysis even in patients without the hemorrhagic manifestations of dengue viral infection and should employ early preventive strategies in such cases.

Expanded dengue syndrome in secondary dengue infection: A case of biopsy proven rhabdomyolysis induced acute kidney injury with intracranial and intraorbital bleeds

“…Renal tubular injury caused by rhabdomyolysis has been scarcely reported among dengue patients. To the best of our knowledge nine such cases have been reported, with only a single biopsy-proven case (Table 1) (4,(16)(17)(18)(19)(20)(21)(22)(23). Three out of the nine patients died, proves the seriousness of this condition (17,20,22).…”

Beyond thrombocytopaenia, haemorrhage and shock: the expanded dengue syndrome

“…Hypokalaemic muscle weakness associated with dengue has been increasingly reported [88][89][90][91][92]. Rhabdomyolysis has been described, sometimes with extremely high CK levels, and can result in acute renal failure and death [93][94][95][96][97][98][99][100][101]. An entity known as dengue associated transient muscle dysfunction (DMAD) has been suggested [102], associated with varying degrees of myalgia, muscle weakness, hyporeflexia, raised CPK; inflammatory changes were seen in muscle in some of these patients [39,102].…”

Clinical Features of and Risk Factors for Rhabdomyolysis Among Adult Patients with Dengue Virus Infection

“…[19][20][21][22][23][24] However, only a few studies on rhabdomyolysis associated with DENV infection are available, and all of them are case reports or literature reviews. [7][8][9][10][11][12][13][14][15][16][17][18] The uncommon and atypical manifestation of dengue-related rhabdomyolysis has limited clinician awareness. Delayed or missed diagnosis and inappropriate treatment of dengue-related rhabdomyolysis could result in serious complications, such as acute kidney injury and even death.…”

“…Delayed or missed diagnosis and inappropriate treatment of dengue-related rhabdomyolysis could result in serious complications, such as acute kidney injury and even death. [7][8][9][10][11][12][13][14][15][16][17][18] To elucidate the clinical features of and risk factors for denguerelated rhabdomyolysis, we conducted a retrospective analysis of patients with dengue that was diagnosed over an 11-year period in a large medical center. We aimed to better understand the demographic, clinical, and laboratory characteristics of rhabdomyolysis in adult dengue patients and identify the risk factor(s) for developing rhabdomyolysis as well as cytokine/ chemokine responses in dengue patients with rhabdomyolysis.…”

“…5,6 As the number of dengue cases is increasing globally, 1 the incidence of rhabdomyolysis associated with DENV infection is also increasing. [7][8][9][10][11][12][13][14][15][16][17][18] Rhabdomyolysis is a potentially life-threatening syndrome characterized by the breakdown of skeletal muscle. 19 Inappropriate treatment of this condition can lead to electrolyte disturbances, metabolic acidosis, coagulation defects, and acute kidney injury.…”