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CASE REPORT
Year : 2020  |  Volume : 40  |  Issue : 3  |  Page : 141-144

Varicella-zoster virus-induced rhabdomyolysis: A case report and literature review


1 Department of Internal Medicine, Division of Infectious Diseases and Tropical Medicine, National Defense Medical Center, Tri-Service General Hospital, Taipei, Taiwan
2 Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, National Defense Medical Center, Tri-Service General Hospital, Taipei, Taiwan
3 Department of Internal Medicine, Division of Nephrology, National Defense Medical Center, Tri-Service General Hospital, Taipei, Taiwan
4 Department of Family Medicine, National Defense Medical Center, Song-Shan Branch, Tri-Service General Hospital, Taipei, Taiwan

Correspondence Address:
Dr. Yao-Hsien Huang
Department of Family Medicine, National Defense Medical Center, Song.Shan Branch, Tri-Service General Hospital, National Defense Medical Center, No. 131, Jiankang Road, Songshan District, Taipei
Taiwan
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jmedsci.jmedsci_114_19

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Infection is a possible cause of rhabdomyolysis. We describe the case of a 63-year-old male with malaise and erythematous papules on the right C5–C7 dermatomes, consistent with herpes zoster. Serum antibody and Tzanck tests of the skin lesion were positive. Increased serum creatine kinase (CK) and myoglobin levels and cola-colored urine indicated the development of rhabdomyolysis. Acute kidney injury was also observed. After excluding other possible predisposing factors, the patient was diagnosed with varicella-zoster virus (VZV)-induced rhabdomyolysis. Extracellular volume with alkalized fluids and topical acyclovir was administered. While CK levels declined to normal by day 13, the renal function was not restored. The skin lesion crusted by day 8 and scaled off gradually by day 13. Our case and literature review highlighted the necessity for systemic antiviral treatment and that poor VZV infection control could lead to irreversible kidney injury. In addition, systemic acyclovir should be administered carefully due to its complication of nephrotoxicity.


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