Salmonella infection can cause an asymptomatic intestinal carrier state or clinical diseases such as enterocolitis presenting abdominal pain, fever, vomiting, or diarrhea. Salmonella usually invades Peyer's patch of terminal ileum or ascending colon. Sepsis is not common and acute renal failure secondary to rhabdomyolysis is rare. The causes of rhabdomyolysis are trauma, excessive exercise, alcohol, seizure, metabolic abnormality, and infection. Infections account for less than 5% of the reported causes of rhabdomyolysis and resulting acute renal failure. The mechanisms underlying rhabdomyolysis due to infection are direct muscle invasion, toxin production, and nonspecific effects that can occur with infections such as fever, dehydration, acidosis, and electrolyte imbalance. We report a case of sepsis and acute renal failure secondary to rhabdomyolysis associated with Salmonella infection.
Colonoscopy ; Enterocolitis/complications/*diagnosis ; Humans ; Kidney Failure, Acute/*diagnosis/etiology ; Male ; Middle Aged ; Rhabdomyolysis/diagnosis/etiology/microbiology ; Salmonella Infections/complications/*diagnosis ; Sepsis/*diagnosis/etiology ; Tomography, X-Ray Computed

Mushroom exposures are increasing worldwide. The incidence and fatality of mushroom poisoning are reported to be increasing. Several new syndromes in mushroom poisoning have been described. Rhabdomyolytic mushroom poisoning is one of new syndromes. Russula subnigricans mushroom can cause delayed-onset rhabdomyolysis with acute kidney injury in the severely poisoned patient. There are few reports on the toxicity of R. subnigricans. This report represents the first record of R. subnigricans poisoning with rhabdomyolysis in Korea, describing a 51-year-old man who suffered from rhabdomyolysis, acute kidney injury, severe hypocalcemia, respiratory failure, ventricular tachycardia, cardiogenic shock, and death. Mushroom poisoning should be considered in the evaluation of rhabdomyolysis of unknown cause. Furthermore, R. subnigricans should be considered in the mushroom poisoning with rhabdomyolysis.
Acute Kidney Injury/*etiology ; Basidiomycota/isolation & purification/*pathogenicity ; Electrocardiography ; Heart Ventricles/physiopathology ; Humans ; Male ; Middle Aged ; Mushroom Poisoning/*diagnosis/microbiology/mortality ; Rhabdomyolysis/*etiology ; Shock, Cardiogenic/*etiology ; Tachycardia, Ventricular/etiology

Cholangitis and cholecystitis are intra-abdominal infections that show poor prognosis upon progression to sepsis and multiorgan failure. Administration of antibiotics with high antimicrobial susceptibility and removal of infected bile at the initial treatment are important. After undergoing ERCP for diagnostic purposes, a 58-year-old man developed acute cholangitis and cholecystitis accompanied by rhabdomyolysis, multi-organ failure, and severe sepsis. Broad-spectrum antibiotics with bedside endoscopic nasobiliary drainage were administered, but clinical symptoms did not improve. Therefore, bedside EUS-guided transgastric gallbladder aspiration and lavage was performed, resulting in successful treatment of the patient. We report the above described case along with a discussion of relevant literature.
Cholangiopancreatography, Endoscopic Retrograde ; Cholecystitis, Acute/complications/*diagnosis/diagnostic imaging ; Drainage ; Duodenoscopy ; Endosonography ; Escherichia coli/isolation & purification ; Humans ; Male ; Middle Aged ; Multiple Organ Failure/pathology ; Rhabdomyolysis/complications/diagnosis ; Sepsis/diagnosis/etiology/microbiology ; Therapeutic Irrigation ; Tomography, X-Ray Computed