Rhabdomyolysis with acute renal failure due to <i>Borrelia burgdorferi</i>

Jeandel, C; Blain, H.; Jouanny, P.; Penin, F.; Laurain, MC

doi:10.1111/j.1365-2796.1994.tb01057.x

Cited by 13 publications

(9 citation statements)

References 2 publications

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“…In another case, preexisting dermatomyositis was exacerbated following infection with B burgdorferi (8). Creatine kinase levels have most often been reported to be normal or only mildly to moderately elevated, but levels of several thousand units per liter have been described in a few cases (7, 8, 12, 13). One case of rhabdomyolysis and acute renal failure associated with borrelial infection has been described, occurring in an 81‐year‐old man who also had staphylococcal septicemia and died due to multiorgan failure (13).…”

Section: Discussionmentioning

confidence: 99%

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Lyme myositis

Holmgren¹,

Matteson²

2006

Arthritis & Rheumatism

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Myositis has been reported as a rare manifestation of Lyme disease, and Lyme myositis can be an important consideration in the differential diagnosis of unusual cases, especially in patients who live in or travel to endemic areas. We report the case of a 43-year-old man who presented with focal myositis of the proximal lower extremity and was subsequently diagnosed as having Lyme myositis. The patient had previously experienced a febrile illness and rash, but had no ongoing symptoms of Lyme disease. Myositis was confirmed by magnetic resonance imaging and muscle biopsy; Borrelia burgdorferi infection was confirmed by Lyme serology and polymerase chain reaction testing of synovial fluid and biopsy material. The current case is reviewed in the context of findings from previous case descriptions. CASE REPORTThe patient, a 43-year-old man from Olmsted County, Minnesota, presented to the emergency department in February 2005 with a 3-week history of left knee and thigh pain and swelling. He first noted symptoms in the posterior aspect of his left knee while sitting at rest. There was no antecedent trauma. The pain first worsened and then improved within 1 week, while the swelling continued to progressively worsen. Approximately 10 days prior to admission, the swelling and pain progressed to include his left thigh and, to a lesser extent, his left calf. The swelling became very pronounced, and his leg felt "tight." Movement of the knee caused pain in his thigh, especially the medial aspect of the thigh, which caused increased difficulty in walking. Two days prior to admission, the patient presented to an outside urgent care facility. A Doppler ultrasound was performed to rule out deep venous thrombosis. The results were negative. He was discharged with instructions to follow up with an orthopedist.On the evening prior to admission, the patient described feeling malaise and, that night, awoke with drenching sweats. He presented to his outpatient appointment the following day, where he was noted to have thigh swelling, a lesser degree of calf swelling, a knee effusion, and intense medial thigh tenderness, but no knee tenderness. A Doppler ultrasound was again performed, but the results remained negative. He was directed to our emergency department, where he was evaluated and admitted to the hospital. Information obtained upon admission revealed no history of fevers, chills, or sweats, except for the previous night. He reported no pain in the ipsilateral calf. There were no other painful or swollen joints or back pain. He had no rash, cough, dyspnea, chest pain, headache, sinus symptoms, urinary symptoms, nausea, vomiting, diarrhea, or hematochezia. His medical history was significant only for hypertension, for which he took atenolol as well as daily aspirin. There was no history of arthritis or gout.Upon examination, the patient was afebrile. He had a large left knee effusion, which was warm but not tender or erythematous. The left thigh was also swollen to a circumference 7 cm greater than that of his right thigh. The ...

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Section: Discussionmentioning

confidence: 99%

“…Other case reports have described similar histopathology (1, 3, 7, 9). However, a necrotizing myopathy has also been described (4, 12, 13). In a nonhuman primate model, plasma cells and CD8+ T cells predominated, and the extent of the inflammatory infiltrate was influenced by the host's immune status (2).…”

Section: Discussionmentioning

confidence: 99%

Lyme myositis

Holmgren¹,

Matteson²

2006

Arthritis & Rheumatism

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“…Lyme disease, caused by Borrelia burgdorferi, can cause localized myositis of the orbits and other sites, often near areas of skin or joint involvement (99,186). A case of rhabdomyolysis associated with Lyme disease has been reported (113). Diagnosis is with a positive Lyme serology confirmed by Western blot analysis.…”

Section: Other Forms Of Bacterial Myositismentioning

confidence: 99%

Bacterial, Fungal, Parasitic, and Viral Myositis

2008

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SUMMARY Infectious myositis may be caused by a broad range of bacterial, fungal, parasitic, and viral agents. Infectious myositis is overall uncommon given the relative resistance of the musculature to infection. For example, inciting events, including trauma, surgery, or the presence of foreign bodies or devitalized tissue, are often present in cases of bacterial myositis. Bacterial causes are categorized by clinical presentation, anatomic location, and causative organisms into the categories of pyomyositis, psoas abscess, Staphylococcus aureus myositis, group A streptococcal necrotizing myositis, group B streptococcal myositis, clostridial gas gangrene, and nonclostridial myositis. Fungal myositis is rare and usually occurs among immunocompromised hosts. Parasitic myositis is most commonly a result of trichinosis or cystericercosis, but other protozoa or helminths may be involved. A parasitic cause of myositis is suggested by the travel history and presence of eosinophilia. Viruses may cause diffuse muscle involvement with clinical manifestations, such as benign acute myositis (most commonly due to influenza virus), pleurodynia (coxsackievirus B), acute rhabdomyolysis, or an immune-mediated polymyositis. The diagnosis of myositis is suggested by the clinical picture and radiologic imaging, and the etiologic agent is confirmed by microbiologic or serologic testing. Therapy is based on the clinical presentation and the underlying pathogen.

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“…Diffuse myalgia and muscle stiffness are common in early infection, but frank myositis has rarely been associated with Lyme disease [10][11][12][13]. These patients usually report muscle pain and weakness.…”

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confidence: 99%

“…The perifascicular atrophy and perivascular, perimysial inflammation are characteristic of dermatomyositis. Cases of Lyme disease presenting as dermatomyositis [16] and rhabdomyolysis complicating severe myositis have been reported [13].…”

mentioning

confidence: 99%