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Marathon Monday


Rhabdomyolysis-60secondEM-300x171A 32 yr old male limps into the emergency department with complaints of general malaise with severe myalgias and arthralgias. He had run the Boston marathon two days ago and began feeling sick yesterday with headache, myalgias, nausea and vomiting.
His vitals signs are normal, but he appears clinically dehydrated and does describe a decrease in urine output over the past 12 hours. He appears very uncomfortable and you begin IV rehydration and decide to check his electrolytes.



Rhabdomyolysis-60secondEM-1-300x225After 1800cc of IV fluids, the patient finally has some Rhabdomyolysis-60secondEM-2urine output.









The urine is dipped in the ED:

Rhabdomyolysis-60secondEM-3-300x225The urine specimen is sent to the lab for a microscopic analysis which reveals “0” RBC’s per HPF.









1. What additional labs should be ordered?

2. What diagnosis should you be concerned about?

3. What is the treatment?

4. What are the possible complications?



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