Severe Rhabdomyolysis With Acute Kidney Injury Triggered by Influenza A and Strenuous Exercise in a Healthy Adolescent: A Dual-Hit Mechanism

Abstract

Rhabdomyolysis is a serious clinical condition often associated with serious complications and can be life-threatening in nature. The following is a case report of a healthy 17-year-old male adolescent who presented with rhabdomyolysis due to a dual hit of Influenza A and excessive physical exertion. Acute onset of myalgia, weakness in the lower extremities, and dark urine warranted his hospitalization in the intensive care unit for critical monitoring and investigation. The laboratory findings indicated a high creatine kinase level of more than 60,000 U/L, severe metabolic acidosis, hyperkalemia, and renal failure. Despite aggressive fluid resuscitation, persistent anuria and metabolic derangements warranted renal replacement therapy with continuous veno-venous hemofiltration followed by intermittent hemodialysis, resulting in progressive recovery of renal function and clinical improvement. This case highlights the importance of recognizing rhabdomyolysis in patients presenting with acute neuromuscular symptoms after febrile illness and strenuous exercise, emphasizing the need for early diagnosis and prompt supportive management to prevent irreversible renal injury.