Rhabdomyolysis associated with influenza A/H1N1 2009 infection in a pediatric patient.

The influenza A/H1N1 2009 epidemic has spread to many countries since 2009, including Japan. We report an immune-competent child involving rhabdomyolysis and compartment syndrome associated with influenza A/H1N1 2009. The patient was demonstrated rhabdomyolysis with myoglobinuria, hyperkalemia, cardiac dysfunction and compartment syndrome that arose during convalescence from influenza A/H1N1 2009 infection. Although RT-PCR of muscle tissue yielded negative results for influenza A/H1N1 2009 RNA and no viral positive-antigen cells were detected in the muscle lesions, the clinical picture suggested rhabdomyolysis associated with influenza A/H1N1. Rhabdomyolysis should be considered in the evaluation of muscle symptoms such as myalgia associated with novel influenza A/H1N1 2009 virus infection, particularly in critically ill patients.