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Rhabdomyolysis: An Unusual Presentation of Tularemia

Wehbe, Edgard MD*; Antoun, Smyrna Abou MD*; Jaoude, Dory Abou MD*; Moussa, Jany MD; Moore, Thomas MD

Infectious Diseases in Clinical Practice: March 2009 - Volume 17 - Issue 2 - p 111-113
doi: 10.1097/IPC.0b013e318173f6e6
Case Reports

Introduction: Rhabdomyolysis is associated with various bacterial and virus infections. The occurrence of rhabdomyolysis with tularemia is very rare and described only in case reports. It is associated with higher morbidity and mortality.

Objectives: In this article, we present a case of severe rhabdomyolysis and tularemia as well as a review of all the cases reported in the English literature.

Main result: Rhabdomyolysis is considered one of the factors associated with a poor outcome in tularemia. It occurs mainly in patients having pneumonic tularemia or bacteremia. Acute kidney injury is a constant finding in all patients.

Conclusions: This case emphasizes the importance of considering the diagnosis of tularemia in patients coming with rhabdomyolysis. Early diagnosis and intervention can lead to better outcome.

From the *Departments of Internal Medicine, †Nephrology, and ‡Infectious Disease, The University of Kansas School of Medicine-Wichita, Wichita, KS.

Reprints: Edgard Wehbe, MD, Department of Internal Medicine, University of Kansas School of Medicine-Wichita, 1010 North Kansas, Wichita, KS 67214. E-mail:

© 2009 Lippincott Williams & Wilkins, Inc.