A Rare Case of Erythromycin-Induced Rhabdomyolysis.

Rhabdomyolysis (RML) arises from the breakdown of muscle tissue, leading to the release of intracellular components into the bloodstream and potentially causing multi-organ failure. Multiple drugs have been reported to cause RML. We present here a rare instance of erythromycin-triggered RML in a patient who was not on any other potential RML-inducing medications. A 25-year-old male presented to the ED complaining of a tingling sensation and increased dyspnea with muscle aches. He took erythromycin over the counter for two days before. On presentation, diffuse muscle tenderness was found, and the vitals showed tachycardia and tachypnea. Labs showed elevated creatinine, peaking at 10.1, and elevated creatine kinase (CK) peaking at 1.2 million. He was treated in ICU with aggressive fluid resuscitation. Then he required dialysis due to fluid overload and not responding to diuretics. Extensive workup failed to find a cause for RML. This represents only the second documented instance of erythromycin-induced RML in a patient who is not concurrently using any other myotoxic medications. Before attributing the patient's condition to the erythromycin he was taking, it was essential to rule out the typical triggers of RML. Every physician must be familiar with the symptoms and prevalent triggers of RML.