A Rare Case of Tularemia Complicated by Rhabdomyolysis with a Successful Outcome

Autor: Ieva Kubiliute, Birute Zablockiene, Rasute Paulauskiene, Giedrius Navickas, Ligita Jancoriene
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Zdroj: Medicina, Vol 57, Iss 5, p 449 (2021)
Druh dokumentu: article
ISSN: 57050449
1648-9144
1010-660X
DOI: 10.3390/medicina57050449
Popis: We present a case of tularemia complicated by rhabdomyolysis in a 43-year-old male who presented with fever, swelling, and pain of the right groin and a history of a week-old tick bite. Empirical parenteral amoxicillin/clavulanic acid treatment was initiated. Suspecting tularemia, parenteral gentamycin was added. Later, the patient started to complain of muscle pain, weakness, and difficulties in breathing and walking. Heightened levels of creatine kinase and myoglobin concentration (42,670 IU/L and >12,000 μg/L, respectively) were found. Due to rhabdomyolysis, large amounts of intravenous fluid therapy were initiated to prevent kidney damage, continuing intravenous antibiotic therapy. Francisella tularensis IgG in serum was found to be positive only on the sixteenth day of hospitalization. Upon discharge, the laboratory analyses returned to normal levels, and the patient was in good condition. The successful outcome could be associated with the early appropriate therapy of tularemia and its rare complication of rhabdomyolysis.
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