Journal
CUREUS JOURNAL OF MEDICAL SCIENCE
Volume 14, Issue 5, Pages -Publisher
CUREUS INC
DOI: 10.7759/cureus.25201
Keywords
creatine phosphokinase; acute renal failure; necrotizing myopathy; rhabdomyolysis; coxsackie b
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Coxsackie B infections can cause necrotizing myopathy and extremely high levels of creatine phosphokinase, and it is associated with high mortality. This case highlights the importance of Coxsackie B4 as a potential pathogen.
Coxsackie B infections can have varying clinical presentations. Necrotizing myopathy and rhabdomyolysis with remarkably high creatine phosphokinase levels is a rare complication associated with high morbidity and mortality. A 28-year-old male presented with complaints of weakness, body aches, and decreased urine output. Initial lab work showed a creatine phosphokinase level estimated at 5,366,100 U/l. Initial Coxsackie B4 titers were at 1:160. Muscle biopsy of the right calf revealed necrotizing myopathy consistent with viral myopathy. This case highlights Coxsackie B4 as a potential pathogen that can cause extensive muscle necrosis producing extreme creatine phosphokinase levels leading to rhabdomyolysis. Taking a comprehensive history is essential to identify viral prodromal symptoms to guide broader serological testing for uncommon viral species.
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