Rhabdomyolysis Following Initiation of Antiviral Therapy with Oseltamivir

Abstract

Patient: Male, 53Final Diagnosis: Rhabdomyolysis with Oselatimivir therapySymptoms: Dark urineMedication: OseltamivirClinical Procedure: —Specialty: HematologyObjective:Adverse events of drug therapyBackground:Tamiflu (oseltamivir phosphate) serves as prophylaxis and treatment of upper respiratory tract infections (URTI) and lower respiratory tract infections (LRTI) caused by viruses of the Orthomyxovirus family. Here, we present a patient with URTI and negative rapid influenza diagnostic testing (RIDT), who developed rhabdomyolysis after being started on oseltamivir.Case Report:Our report describes a rare case of rhabdomyolysis after oseltamivir administration in a 53-year-old man with suspected influenza. We discuss the differential diagnosis for rhabdomyolysis to rule out other causes and review the literature on influenza-induced rhabdomyolysis.Conclusions:Considering the serious consequences of rhabdomyolysis, care needs to be taken in routine prescription and use of oseltamivir. Although this is a rare adverse effect, our case highlights the need to be vigilant for uncommon adverse events with commonly used drugs.

Influenza-induced rhabdomyolysis

“…He required vasopressors briefly on day 1 of his hospitalisation making sepsis an unlikely cause of the rhabdomyolysis. Oseltamivir has also been implicated as a rare aetiology of rhabdomyolysis 4–6. In our case, the patient presented with an elevated CK level of 3043 U/L at admission making it less likely the inciting event.…”

Influenza A (H3N2) infection followed by anti-signal recognition particle antibody-positive necrotizing myopathy: A case report

“…In this case, the disease process and immune response against the influenza A (H3N2) virus may have induced the production of anti-SRP antibodies and worsened her myositis. Rhabdomyolysis caused by influenza virus itself or a drug (statin or oseltamivir (Puttagunta et al, 2018)) could be another differential diagnosis for the present case. However, renal dysfunction, which is usually correlated with a greater degree of rhabdomyolysis with severe muscular symptoms (Borgatta et al, 2012), was not observed in this patient; moreover, she did not respond to hydration treatment.…”