Sports Medicine
Dylan M. Wood, MD
Resident Physician
University of Miami Jackson Health
Miami, Florida, United States
Daniel Wang, DO
Resident Physician
University of Miami Miller School of Medicine/Health System
Miami, Florida, United States
Nicole Pontee, MD
Assistant Professor
Jackson Health Systems/University of Miami
Miami, Florida, United States
Dylan M. Wood, MD
University of Miami Jackson Health
Miami, Florida, United States
Viral Myositis is an acute, self-limited, inflammatory condition of skeletal muscle caused by viral infection. This is most commonly seen in male children with symptoms such as sudden onset bilateral lower extremity pain, difficulty walking, and elevated CK values.
Case Description:
19 year-old-male with history of long-distance running who presented with bilateral lower extremity pain in the setting of recent COVID-19 and influenza infection resulting in viral myositis, subsequent rhabdomyolysis, bilateral upper and lower extremity four-compartment fasciotomies, and further complicated by poor wound healing due to mucormycosis with bilateral above knee guillotine amputations. Patient underwent intensive acute inpatient rehabilitation for three weeks and at time of discharge was moderate assist with slideboard transfers and was modified independent in wheelchair mobility.
Discussions:
Viral myositis is a rare condition that normally occurs in childhood/adolescence after an influenza infection. One single-center 5-year retrospective study found that 80% of their viral myositis cases were associated from an influenza antecedent event. Furthermore, 85% of cases were from May-October (peak influenza season), and 82% were male. A systemic review identifying benign acute childhood myositis found the mean age of patients was 6.8 years old, more prevalent in males (92%) had bilateral leg pain followed by fever (80%), and inability to walk (56%) with Influenza-B being the most common etiology.
Conclusions:
Viral Myositis, though rare, can have symptoms ranging from benign to catastrophic. This is most commonly seen in males with bilateral lower extremity pain following a recent viral illness. Understanding the severity of the disease process can help the physiatrist understanding not only the functional limitations that can occur afterwards but also the mental barriers given the acuity of illness and affected demographic.
