Archives of the Balkan Medical Union (Sep 2020)
Rhabdomyolysis accompanying the staphylococcal sepsis
Abstract
Introduction. Rhabdomyolysis (RM) is a clinical and laboratory syndrome resulting from skeletal muscle damage, with the release of a big number of intracellular substances of myocytes into the systemic circulation and endotoxemia. The entry of the muscle destruction products into the systemic circulation leads to the development of systemic manifestations, serious disorders in homeostasis, multiple organ failure syndrome, including acute renal failure, often threatening the patient’s life. Case report. A rare case of RM in a patient with staphylococcal sepsis (SS) and development of multiple organ failure is described. The diagnosis of RM was confirmed by the results of pathological and anatomical studies. Possible causes of RM in staphylococcal sepsis are discussed here. Conclusions. Only a few cases of RM upon SS were found in the literature. The development of RM in combination with the systemic inflammatory reaction syndrome in SS exacerbates the course of the disease and worsens its prognosis. Therefore, the timely diagnosis of RM and appropriate treatment are extremely important. The mechanism of RM development upon SS is complex. After staphylococcus was isolated from the affected muscles in a patient with SS, one of the first descriptions of RM upon SS suggested the role of direct invasion of the infectious agent into the muscles, followed by the development of “pyomyositis.” Another mechanism for RM occurrence of PM may be the presence of toxin upon the staphylococcal toxic shock syndrome in patients with SS.
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