Rhabdomyolysis Induced by Parainfluenza 2 Virus in a Healthy 18-Year-Old Male Patient: A Case Study.

BACKGROUND Rhabdomyolysis is a medical condition characterized by the cellular breakdown of skeletal muscle tissue, leading to the release of basic muscle components into the bloodstream. Multiple causes have been reported, including infections that involve skeletal muscle cells. One of the most common classes of infections causing rhabdomyolysis is viral in origin. Clinically, the patient usually reports a short latency period consisting of malaise followed by muscle soreness, myalgia, and even an antalgic gait. Higher degrees of skeletal muscle damage result in higher levels of serum myoglobin. When the levels of myoglobin exceed the protein binding capacity, the molecule can precipitate during glomerular filtration and damage the kidneys. CASE REPORT An 18-year-old healthy, active male patient was brought to the Emergency Department (ED) after experiencing 5 days of generalized malaise and 2 days of progressively debilitating skeletal muscle pain and malfunction, leading to the inability to walk. He had dismissed the symptoms until he was non-ambulatory. On arrival at the ED, his creatine kinase (CK) level was elevated at 6859 U/L (reference, 10-70 U/L), and parainfluenza type 2 virus was identified by a nasopharyngeal respiratory polymerase chain reaction panel. He received symptomatic treatment including acetaminophen, methocarbamol, and diuresis. He was discharged on day 5, and his CK level returned to normal by day 12 of his disease. CONCLUSIONS Parainfluenza virus is a rare cause of rhabdomyolysis. If the myalgia of a common "cold or flu" progresses to muscle swelling and tenderness, especially in the lower extremities, and impairs ambulation, urgent medical evaluation should be considered.