A 22-year-old man was admitted to the National Hospital Organization Osaka National Hospital for skin ulcers and chronic osteomyelitis. He did not have any renal dysfunction, and the wound culture on the fourth hospital day revealed the presence of methicillin-resistant Staphylococcus aureus. Therefore, he was treated with teicoplanin and vancomycin. However, a rash and pruritus appeared, following which these drugs were discontinued.
On the 25th hospital day, his creatine phosphokinase (CPK) level was 104 IU/L, and on the 28th hospital day, he was started on daptomycin therapy (4 mg/kg/day). However, on the fourth day of daptomycin therapy, his CPK level rapidly increased to 2648 IU/L, and daptomycin was immediately discontinued.
To our knowledge, thus far, there have been no reports worldwide of a patient with normal renal function who showed an increase in the CPK levels in early stage disease, due to daptomycin administration. Therefore, we believe that monitoring of CPK levels at the early stage of disease is important even in patients with normal kidney function.
