Rhabdomyolysis induced by Pseudomonas aeruginosa sepsis

We describe advanced hemodynamic insufficiency and remarkably high myoglobinemia in a 77-year-old man who was admitted to the intensive care unit after total aortic arch replacement. Serum myoglobin showed an unusually high value (peak value, 155 030 ng·ml −1 ). The patient died of sepsis and untreatable metabolic acidosis. Pseudomonas aeruginosa was detected in blood culture specimens after his death. On histopathological examination, dense congregations of gramnegative bacilli were present in clots in blood vessels, while congregations of gram-negative bacilli around the circumference of small blood vessels were particularly apparent in every specimen examined. Moreover, a generalized breakdown of muscle fibers, consistent with findings of rhabdomyolysis, was observed in muscle tissue throughout the body.