Rhabdomyolysis and Pandemic (H1N1) 2009 Pneumonia in Adult

摘要

To the Editor: A 56-year-old man came to the emergency depart-ment (ED) of Malcolm Grow Medical Center at Andrews Air Force Base in suburban Maryland, USA, just outside Washington, DC. He had a history of several days of cough, fever, and malaise; was a nonsmoker; was over-weight (body mass index 28 kg/m2); and did not have chronic pulmonary disease. Radiographs showed bilateral pulmonary infi ltrates, and he was hy-poxemic. Two weeks previously, the patient had begun receiving therapy for recurrent multiple myeloma (le-nalidomide and high-dose dexametha-sone). He was intubated at the time of initial visit to the ED for in. uenza symptoms, and broad-spectrum an-timicrobial drugs were administered (vancomycin 1,000 mg every 12 h, piperacillin-tazobactam 4.5 gm every 6 h, and levo. oxacin 750 mg 1×/d). Initial nasopharyngeal wash was neg-ative for in. uenza A and B antigen by enzyme immunoassay; serum creatine kinase was 271 U/L (reference range 38–174 U/L).