Dark urine as the initial manifestation of COVID-19: a case report. J Med Case Rep 2021 Dec 02;15(1):576
Date
12/04/2021Pubmed ID
34857045Pubmed Central ID
PMC8637504DOI
10.1186/s13256-021-03173-xScopus ID
2-s2.0-85120746416 (requires institutional sign-in at Scopus site) 2 CitationsAbstract
BACKGROUND: Rhabdomyolysis is defined as a syndrome consisting of muscle necrosis and the release of intracellular muscle components into the bloodstream. Although rhabdomyolysis has been previously reported as an initial presentation or late complication of COVID-19, the data on it is still limited, and currently, there is no single case of COVID-19 in the literature that describes creatine kinase levels of more than 30,000 IU/L.
CASE PRESENTATION: A 50-year-old African-American male presented to the hospital with decreased urine output, dark urine color, and constipation for the past couple of days. He was found to have acute kidney injury, liver injury, and creatinine kinase of 359,910 IU/L, for which aggressive intravenous fluid therapy was given. Infectious workup resulted in positive severe acute respiratory syndrome coronavirus 2 polymerase chain reaction. Two days after admission, the patient became symptomatic from a coronavirus disease 2019: he developed fever and hypoxia, and was placed on supplemental oxygen and started on a 10-day course of dexamethasone. The patient responded well to the treatment and supportive care for coronavirus disease 2019 and was successfully discharged.
CONCLUSION: Clinicians should be cognizant of atypical coronavirus disease 2019 presentations. The spectrum of damage of coronavirus disease 2019 is still an evolving topic, and more research is required to reveal the exact mechanisms by which severe acute respiratory syndrome coronavirus 2 leads to rhabdomyolysis.
Author List
Egoryan G, Chaudry S, Yadav K, Dong T, Ozcekirdek E, Ozen E, Rodriguez-Nava GAuthor
Emre Ozcekirdek MD Assistant Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Acute Kidney InjuryCreatinine
Humans
Male
Middle Aged
Rhabdomyolysis