Community-acquired pneumonia complicated by rhabdomyolysis: A clinical analysis of 11 cases

Table 1 Baseline characteristics and prognoses of patients with rhabdomyolysis induced by community-acquired pneumonia

Case	Age(yr)	Sex	Diagnosis	BMI	Maximum temperature (°C)	Symptoms	AKI	Hospitalstay (d)	Outcome	PSI
1	52	Male	CAP	24.5	41.0	Tiredness, myalgia sometimes	No	11	Cured	67
2	65	Male	SCAP	20.3	39.3	Soy urine hypourocrinia	Yes	25	Cured	105
3	56	Male	CAP	21.7	39.4	Hypourocrinia	Yes	14	Cured	66
4	22	Male	CAP	27.8	40.0	Tired	Yes	7	Cured	37
5	32	Male	SCAP	33.9	40.6	Myalgia, tiredness	No	23	Cured	67
6	72	Male	SCAP	20.3	39.7	None	No	3	Died	112
7	86	Male	CAP	19.5	38.3	Hypourocrinia	Yes	18	Cured	86
8	84	Male	SCAP	-	40.7	None	Yes	44	Cured	99
9	76	Male	SCAP	-	40.5	None	Yes	18	Died	161
10	81	Male	CAP	21.5	38.9	Myalgia, tiredness	No	11	Cured	131
11	48	Male	CAP	21.2	37.3	Soy urine, myalgia	Yes	8	Cured	48

AKI: Acute kidney injury; BMI: Body mass index; CAP: Community-acquired pneumonia; SCAP:Severe community-acquired pneumonia; PSI: Pneumonia severity index.

Table 2 Comparison of baseline characteristics and prognosis in patients with rhabdomyolysis induced by community-acquired pneumonia and by exercise

	Age (yr)	Sex	BMI	Maximum temperature (°C)	AKI	Hospital stay (d)	Outcome
CAP (n = 11)	61.27 ± 21.34	Male 11 Female 0	23.41 ± 6.70	39.7 (38.9,40.6)	7 (63.63%)	16.55 ± 11.34	Cured 9 Died 2
Exercise(n = 48)	23.29 ± 8.06	Male 43 Female 5	25.02 ± 4.15	36.9 (36.8, 37.0)	8 (16.67%)	9.83 ± 3.83	Cured 48 Died 0
F/Z/X2	27.38	1.25	0.15	-5.03	10.41	13.96	9.03
P	< 0.05	> 0.05	> 0.05	< 0.05	< 0.05	< 0.05	< 0.05

AKI: Acute kidney injury; BMI: Body mass index; CAP: Community-acquired pneumonia.

Table 3 Test parameters of patients with rhabdomyolysis induced by community-acquired pneumonia

Parameters	Case 1	Case 2	Case 3	Case 4	Case 5	Case 6	Case 7	Case 8	Case 9	Case 10	Case 11
WBC (3.9-9.7 × 109/L)	7.2	9.2	14.2	3.9	6.1	16.1	11.4	11.0	9.38	7.6	12.0
CRP (0-8 mg/L)	121	318	311	20.6	20.8	340	277	100	37.1	142	5.4
PCT (< 0.05 ng/mL)	0.285	11.49	8.82	0.26	2.17	4.72	0.235	0.418	0.17	0.182	0.071
pH (7.35-7.45)	7.420	7.480	7.446	7.405	7.456	7.460	7.467	7.40	7.450	7.423	7.450
PaCO2 (35-45 mmHg)	38	31	34.8	35.2	30.2	30.1	37.6	37	30	35.9	40
PaO2 (80-100 mmHg)	83	69	86.7	84.2	57.5	51.9	62.5	87	68	64.6	76
HCO3-(AB) (22-27 mmol/L)	24.2	23.1	24.8	21.6	26.2	22.9	26.8	22.9	20.9	23.0	27.8
CKmax (29-200 U/L)	11470	10486	6275.6	2489.3	14090.4	1007.3	1301.8	1651	16000	1888.6	81402
Mbmax (0-105.7 μg/L)	975.5	1176.5	1021.6	314.6	3277.3	243.3	456.4	-	3804	564.2	3804
Peak days	5	5	5	6	7	5	6	7	4	9	6
SCr (45-84 μmol/L)	73	159.6	268.9	111.3	105.8	93.7	61.9	129.2	130.7	102.6	53
BUN (2.5-7.2 mmol/L)	3.31	13.02	14.34	5.16	4.85	8.12	7.86	10.55	18.69	11.12	6.44
K+ (3.5-5.5 mmol/L)	3.09	3.56	3.53	4.02	3.0	3.45	3.63	3.74	4.11	3.81	4.75
CTnI (0-0.04 μg/L)	0.06	0.36	0.06	0.01	0.07	0.07	0.04	0.16	1.562	0.03	0.00
AST (5-34 U/L)	38	3939	211	98	819	59	30	72	132	96	1586.7
ALT (0-40 U/L)	16	748	74	77	134	26	22	53	22	50	989.8
LDH (125-243 U/L)	1072	1519	373	460	1711	368	233	437	2625	326	834

ALT: Alanine aminotransferase; AST: Aspartate transaminase; BUN: Blood urea nitrogen; CK: Creatine kinase; CRP: C-reactive protein; CTnI: Cardiac troponin I; HCO3: bicarbonate; LDH: Lactate dehydrogenase; Mb: Myoglobin; PaCO₂: Partial pressure of carbon dioxide; PaO₂: partial pressure of oxygen; PCT: Procalcitonin; SCr: Serum creatinine; WBC: White blood cell.

Table 4 Comparison of test parameters in patients with rhabdomyolysis induced by community-acquired pneumonia and by exercise

Parameters	CAP (n = 11)	Exercise (n = 48)	F/Z/X2	P value
WBC (3.9-9.7 × 109/L)	9.83 ± 3.59	8.97 ± 2.89	1.40	> 0.05
CRP (0-8 mg/L)	153.90 ± 132.93	7.90 ± 5.60	157.79	< 0.05
pH (7.35-7.45)	7.44 ± 0.03	7.39 ± 0.04	1.34	< 0.05
Oxygenation index (mmHg)	304.60 ± 76.89	436.64 ± 38.84	3.72	< 0.05
CKmax (29-200 U/L)	6275.60 (1651.00, 14090.40)	60300.00 (16240.75, 89531.75)	-4.29	< 0.05
Mbmax (0-105.7 μg/L)	998.55 (420.95, 3408.98)	3809.30 (2643.65, 3934.25)	-3.01	< 0.05
Peak days	6 (5, 7)	4 (3, 5)	-3.83	< 0.05
SCr (45-84 μmol/L)	105.80 (73.00, 130.70)	68.10 (62.25, 80.07)	-2.66	< 0.05
BUN (2.5-7.2 mmol/L)	8.12 (5.16, 13.02)	4.06 (3.31, 4.76)	-3.76	< 0.05
K+ (3.5-5.5 mmol/L)	3.70 ± 0.49	4.12 ± 0.32	1.57	< 0.05
AST (5-34 U/L)	98 (59, 819)	1360 (909.5, 1819.15)	-3.10	< 0.05
ALT (0-40 U/L)	53 (22, 134)	354 (246, 444)	-3.03	< 0.05
LDH (125-243 U/L)	460 (368, 1519)	2177 (1069.5, 3130)	-3.15	< 0.05

ALT: Alanine aminotransferase; AST: Aspartate transaminase; BUN: Blood urea nitrogen; CK: Creatine kinase; CRP: C-reactive protein; CTnI: Cardiac troponin I; HCO3: bicarbonate; LDH: Lactate dehydrogenase; Mb: Myoglobin; PaCO₂: Partial pressure of carbon dioxide; PaO₂: partial pressure of oxygen; PCT: Procalcitonin; SCr: Serum creatinine; WBC: White blood cell.