A rare case of adult herpes simplex encephalitis complicated with rhabdomyolysis

BMC Infectious Diseases - Tập 21 - Trang 1-4 - 2021
Qinwei Yu1, Chao Han2, Lei Pei3, Jinsha Huang1, Yan Xu1, Tao Wang1
1Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
2Department of Neurology, Division of Life Sciences and Medicine, the First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, China
3Traditional Chinese Medicine Hospital of Gongan County, JingZhou, China

Tóm tắt

Compelling evidence indicates that status epilepticus is a prevalent cause of rhabdomyolysis. However, cases of rhabdomyolysis induced by a single seizure accompanied by viral encephalitis are rarely reported. Herein, we present a case of adult Herpes Simplex Encephalitis complicated with rhabdomyolysis. A 32-year-old male was patient presented with fever accompanied by episodes of convulsions, myalgia, and oliguria, which exacerbated the delirium. Routine blood examination showed impaired kidney function and elevated myoglobin (Mb) and creatine phosphokinase (CK) levels. MRI scanning revealed a damaged frontotemporal lobe and limbic system. In addition, herpes simplex virus (HSV) pathogen was identified in the cerebrospinal fluid thus indicating HSV infection. Therefore, a diagnosis of rhabdomyolysis triggered by HSV infection accompanied by epilepsy was made. Notably, the patient recovered well after early intervention and treatment. The case presented here calls for careful analysis of rhabdomyolysis cases with unknown causes, minor seizures, and without status epilepticus. This case also indicates that HSV virus infection might contribute to the rhabdomyolysis.

Tài liệu tham khảo

Ayala E, Kagawa FT, Wehner JH, Tam J, Upadhyay D. Rhabdomyolysis associated with 2009 influenza A (H1N1). Jama. 2009;302(17):1863–4. Bagley WH, Yang H, Shah KH. Rhabdomyolysis. Intern Emerg Med. 2007;2(3):210–8. Bradshaw MJ, Venkatesan A. Herpes simplex virus-1 encephalitis in adults: pathophysiology, diagnosis, and management. Neurotherapeutics. 2016;13(3):493–508. Misra UK, Tan CT, Kalita J. Viral encephalitis and epilepsy. Epilepsia. 2008;49(Suppl 6):13–8. Singhal PC, Chugh KS, Gulati DR. Myoglobinuria and renal failure after status epilepticus. Neurology. 1978;28(2):200–1. Lin AC, Lin CM, Wang TL, Leu JG. Rhabdomyolysis in 119 students after repetitive exercise. Br J Sports Med. 2005;39(1):e3. Shanmugam S, Seetharaman M. Viral rhabdomyolysis. South Med J. 2008;101(12):1271–2. Singh U, Scheld WM. Infectious etiologies of rhabdomyolysis: three case reports and review. Clin Infect Dis. 1996;22(4):642–9. Pratt RD, Bradley JS, Loubert C, LaRocco A Jr, McNeal RM, Newbury RO, Sawyer MH. Rhabdomyolysis associated with acute varicella infection. Clin Infect Dis. 1995;20(2):450–3. Khan FY. Rhabdomyolysis: a review of the literature. Neth J Med. 2009;67(9):272–83. McMahon GM, Zeng X, Waikar SS. A risk prediction score for kidney failure or mortality in rhabdomyolysis. JAMA Intern Med. 2013;173(19):1821–8.