[Rhabdomyolysis associated with respiratory infection in chronic psychiatric patients during neuroleptic treatment].
Rhabdomyolysis is a disorder characterized by skeletal muscle injury and fatal complications at times. The causes of rhabdomyolysis are usually traumatic and non-traumatic, such as neuroleptic malignant syndrome and rhabdomyolysis associated to septicemia. The cases of 2 schizophrenic patients with rhabdomyolisis during pneumonia infection and neuroleptic therapy are reported. At admission, both patients had important respiratory distress and hyperthermia; the clinical conditions required endotracheal intubation. Blood and urine cultures were always negative, while the bronchial sputum culture was positive. The diagnosis of rhabdomyolysis was confirmed by myoglobinemia dosage and ortholuidine test. Pneumonia infection was treated with antibiotic specific therapy whereas renal failure was treated with adequate hydratation and strained diuresis. The absence of muscle rigidity, the improvement of X-r images and the reduction of corporeal temperature, during antibiotic treatment, excluded neuroleptic malignant syndrome. The impro-vement allowed extubation and discharge of the patients from intensive care unit. In both cases neuroleptic malignant syndrome was excluded, therefore rhabdomyolysis was the consequence of pneumonia infection or of a combination of factors capable to cause an important damage of skeletal muscles.
Pezza
M
M
Cattedra di Anestesia e Rianimazione, Università degli Studi "Federico II", Napoli, Italy.
Busiello
L
L
Palmese
S
S
Cascella
M
M
Di Domenico
M G
MG
De Robertis
E
E
D058186:Acute Kidney Injury / Q000209:etiology; D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001569:Benzodiazepines; D003937:Diagnosis, Differential; D005334:Fever / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009127:Muscle Rigidity; D009459:Neuroleptic Malignant Syndrome / Q000175:diagnosis*; D000077152:Olanzapine; D010890:Pirenzepine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D018410:Pneumonia, Bacterial / Q000150:complications*; D012206:Rhabdomyolysis / Q000175:diagnosis / Q000209:etiology*; D018967:Risperidone / Q000009:adverse effects / Q000627:therapeutic use; D012559:Schizophrenia / Q000150:complications* / Q000188:drug therapy
D014150:Antipsychotic Agents; D001569:Benzodiazepines; D010890:Pirenzepine; D018967:Risperidone; D000077152:Olanzapine