Rhabdomyolysis induced acute kidney injury after dengue infection

Abstract

Rhabdomyolysis is the breakdown of striated skeletal muscle tissue, leading to the release of cellular elements such as myoglobin, creatine kinase, aldolase, lactate dehydrogenase, and electrolytes into the blood circulation. It’s usually caused by trauma or certain medications, but it can also happen during viral infections like dengue fever, though this is rare and serious. We describe a case of a 33-year-old man with dengue fever who was admitted to the hospital with high fever, nausea, vomiting, and dark urine. Investigations showed high levels of creatine phosphokinase (CPK) and abnormal liver enzymes, suggesting rhabdomyolysis and acute liver injury. Regardless of treatment with fluids and antibiotics, his kidney function got worse, needing hemodialysis. After discharge, he had high blood pressure and required more dialysis sessions. With good care, his kidneys started working better, and the catheter used for dialysis was removed. Rhabdomyolysis from Dengue infection is hard to diagnose and treat. The virus can directly harm muscle cells and cause immune reactions that release harmful substances like myoglobin, which may cause acute kidney injury. Early detection of high CPK levels is crucial to prevent kidney injury. Treatment involves giving fluids carefully to protect the kidneys from myoglobin damage without causing fluid overload, which is critical in helping patients recover. Monitoring CPK levels in Dengue patients is vital to diagnose rhabdomyolysis early and protect the kidneys. This approach can improve outcomes and guide better treatment decisions for patients with this rare but severe complication.