Summary
Infection with Epstein-Barr virus (EBV) is common and induces a broad spectrum of illness. In the majority of cases the disease manifests with typical signs of heterophile-positive infectious mononucleosis in which myalgia may be seen in up to 20% of cases. In this study, a case of rhabdomyolysis is reported occurring during the clinical course of an 18-year-old patient with infectious mononucleosis. This severe form of muscle involvement has been rarely associated with EBV infections. Five similar cases previously published in the English literature are also reviewed. The clinical implications of rhabdomyolysis and infectious mononucleosis are discussed.
Zusammenfassung
Die Infektion mit dem Epstein-Barr-Virus (EBV) ist häufig, sie verursacht ein breites Spektrum von Krankheitsbildern. Die meisten Infektionen verlaufen mit dem typischen Bild einer infektiösen Mononukleose mit heterophilen Antikörpern, in bis zu 20% der Fälle treten Myalgien auf. Wir berichten über einen 18jährigen Mann, bei dem im Verlauf einer infektiösen Mononukleose eine Rhabdomyolyse auftrat. Diese schwere Form der Muskelbeteiligung wird bei EBV-Infektionen selten gesehen. Über fünf ähnliche, in der englischsprachigen Literatur mitgeteilte Fälle wird ebenfalls berichtet. Die klinischen Folgen einer Rhabdomyolyse bei infektiöser Mononukleose werden diskutiert.
Similar content being viewed by others
References
Epstein, M. A., Achong, B. G. Pathogenesis of infectious mononucleosis. Lancet ii (1977) 1270–1272.
Schooley, R. T., Dolin, R. Epstein-Barr virus (infectious mononucleosis). In:Mandell, G. L., Douglas, Jr., R. G., Bennett, J. E. (eds.): Principles and practice of infectious diseases. 3rd ed. Churchill Livingstone, New York 1990, 1172–1185.
Purtilo, D. T., Sakamoto, K. Epstein-Barr virus and human disease: immune responses determine the clinical and pathological expression. Hum. Pathol. 12 (1981) 677–679.
Poels, P. J., Ewals, J. A., Joosten, E. M., Van Loon, A. M. Rhabdomyolysis associated with simultaneous Epstein-Barr virus infection and isolation of echovirus 6 from muscle: a dual infection. J. Neurol. Neurosurg. Psychiatry 52 (1989) 412–414.
Schlesinger, J. J., Gandara, D., Bensch, K. G. Myoglobinuria associated with herpes group viral infection. Arch. Intern. Med. 138 (1978) 422–424.
Kantor, R. J., Norden, C. W., Wein, T. P. Infectious mononucleosis associated with rhabdomyolysis and renal failure. South. Med. J. 71 (1978) 346–349.
Friedman, B. I., Libby, R. Epstein-Barr virus infection associated with rhabdomyolysis and acute renal failure. Clin. Pediatr. (Phila.) 25 (1986) 228–229.
Zappacosta, A. R. Myoglobinuria associated with mononucleosis. J. Am. Med. Wom. Assoc. 32 (1977) 428–430.
Odeh, M. The role of reperfusion-induced injury in the pathogenesis of the crush injury. N. Engl. J. Med. 324 (1991) 1417–1422.
Swartz, M. N. Myositis. In:Mandell, G. L., Douglas, Jr., R. G., Bennett, J. E. (eds.): Principles and practice of infectious diseases. 3rd ed. Churchill Livingstone, New York 1990, 812–818.
Kessler, H. A., Trenholme, G. M., Harris, A. A., Levin, S. Acute myopathy associated with influenza A/Texas/1/77 infection. Isolation of virus from a muscle biopsy specimen. JAMA 243 (1980) 461.
Tang, T., Sedmak, G. V., Siegesmund, K. A., McCreadie, S. R. Chronic myopathy associated with coxsackie virus type A-9. A combined electron microscopical and viral isolation study. N. Engl. J. Med. 292 (1975) 608–611.
Wright, J., Couchonnal, G., Hodges, G. R. Adenovirus type infection. JAMA 241 (1979) 2420–2421.
Fukuyama, Y., Ando, T., Yokata, J. Acute fulminant myoglobinuric polymyositis with picorna virus-like crystals. J. Neurol. Neurosurg. Psychiatry 40 (1977) 775–781.
Gabow, P. A., Kahny, W. D., Kellehner, S. P. The the spectrum of rhabdomyolysis. Medicine 61 (1982) 141–152.
Eneas, J. F., Schoenfeld, P. Y., Humphreys, M. H. The effect of infusion of mannitol-sodium-bicarbonate on the clinical course of myoglobinuria. Arch. Intern. Med. 139 (1979) 801–805.
Ron, D., Taitelman, U., Michaelson, M., Bar-Joseph, G., Bursztein, S., Better, O. S. Prevention of acute renal failure in traumatic rhabdomyolysis. Arch. Intern. Med. 144 (1984) 277–280.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Osamah, H., Brook, J.G. & Finkelstein, R. Rhabdomyolysis complicating acute Epstein-Barr virus infection. Infection 23, 119–120 (1995). https://doi.org/10.1007/BF01833879
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01833879