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Medical Student

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Internal Medicine

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Clinical Science

Abstract

In phase III clinical trials, the use of Daptomycin was associated with an increase in creatinine phosphokinase (CPK) levels in 2.8% of patients treated. Elevation of CPK levels greater than 5 times the upper limit of normal (10-120 mcg/L), indicates a probable diagnosis of rhabdomyolysis. Rhabdomyolysis is the breakdown of skeletal muscle and subsequent leakage of contents into the blood, causing extreme weakness and pain.

A 50-year-old male with a past medical history of chronic osteomyelitis, presented to the ED with right foot pain with swelling. He was subsequently started on Daptomycin. During this time his CPK level was within normal limits, and was discharged to continue receiving IV Daptomycin at an outpatient infusion unit. A few days later, the patient returned with progressively worsening pain and swelling of his arms and hands along with multiple episodes of dark brown urine. Labs revealed a CPK level of 7369, an AST elevated at 304, and an increased BUN/Cr. Findings were consistent with rhabdomyolysis, likely secondary to IV Daptomycin.

Rhabdomyolysis secondary to the use of IV Daptomycin is a rare and unusual adverse effect requiring rapid recognition and aggressive treatment with intravenous fluid resuscitation. Although uncommon, clinicians must be aware of such potential complications, and demonstrate a high level of suspicion in patients presenting with muscle pain and weakness, after treatment with Daptomycin. Due to the life-threatening potential of rhabdomyolysis, frequent monitoring of CPK during extended use of Daptomycin is essential for early diagnosis, and can serve to prevent fatal outcomes.

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How to get Ripped Muscles in 7 Days: A Case of Daptomycin-Induced Rhabdomyolysis

In phase III clinical trials, the use of Daptomycin was associated with an increase in creatinine phosphokinase (CPK) levels in 2.8% of patients treated. Elevation of CPK levels greater than 5 times the upper limit of normal (10-120 mcg/L), indicates a probable diagnosis of rhabdomyolysis. Rhabdomyolysis is the breakdown of skeletal muscle and subsequent leakage of contents into the blood, causing extreme weakness and pain.

A 50-year-old male with a past medical history of chronic osteomyelitis, presented to the ED with right foot pain with swelling. He was subsequently started on Daptomycin. During this time his CPK level was within normal limits, and was discharged to continue receiving IV Daptomycin at an outpatient infusion unit. A few days later, the patient returned with progressively worsening pain and swelling of his arms and hands along with multiple episodes of dark brown urine. Labs revealed a CPK level of 7369, an AST elevated at 304, and an increased BUN/Cr. Findings were consistent with rhabdomyolysis, likely secondary to IV Daptomycin.

Rhabdomyolysis secondary to the use of IV Daptomycin is a rare and unusual adverse effect requiring rapid recognition and aggressive treatment with intravenous fluid resuscitation. Although uncommon, clinicians must be aware of such potential complications, and demonstrate a high level of suspicion in patients presenting with muscle pain and weakness, after treatment with Daptomycin. Due to the life-threatening potential of rhabdomyolysis, frequent monitoring of CPK during extended use of Daptomycin is essential for early diagnosis, and can serve to prevent fatal outcomes.

 

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