Abstract
A 78-year-old man with type 2 diabetes mellitus admitted for fever and muscular weakness had elevated serum creatine kinase (CK) and myoglobin. Chest radiography showed right upper lobe infiltrates. We diagnosed this as rhabdomyolysis following pneumonia. He was immediately treated with cefotaxime and rehydration. CK progressively rose, peaking at 5549 IU/l on hospital day 6 and decreasing thereafter to a normal level as pneumonia improved. He recovered well without renal failure. Pathogenic bacteria were not determined. Rhabdomyolysis may be seen following viral infections, and has rarely been reported in cases of bacterial pneumonia. Bacterial pneumonia is common in elderly diabetic patients, and precipitates dehydration, hyperglycemia, and electrolyte disturbance. Diabetes is known to predispose patients with hyperosmolarity to rhabdomyolysis, but our case shows that diabetic patients with bacterial infections are also at risk for rhabdomyolysis.
