SHM Converge Scientific Abstract ePoster Gallery-A Sudden Turn: Examining a Fatal Case of Accelerated Inflammatory Myositis

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This case report describes a 69-year-old man who presented with 5 days of worsening generalized weakness, watery diarrhea, acute kidney injury, and markedly elevated creatine kinase (CK 11,000), with positive testing for <em>Clostridium difficile</em>. Initially treated with antibiotics and IV fluids, his diarrhea improved, but weakness persisted and CK rose further to 15,000, prompting evaluation for inflammatory myositis. A myositis panel later returned positive for anti-JO-1, anti-SSA-52, anti-Smith-RNP, and Scl-100, and pulse-dose steroids led to temporary improvement.

After transition to oral steroids, however, his condition rapidly deteriorated. He developed worsening weakness, inability to clear secretions, acute respiratory distress, and required intubation. Imaging suggested pneumonia progressing to septic shock and ARDS. Despite aggressive treatment, he remained acidotic, and an emergent laparotomy showed global intestinal hypoperfusion. The patient and family chose comfort-focused care, and he died shortly thereafter.

The authors emphasize that idiopathic inflammatory myositis is usually chronic and indolent, but can vary widely in presentation and severity. They note that respiratory muscle involvement, including diaphragmatic dysfunction, is a serious and sometimes subtle complication that contributes to morbidity and mortality. The case is notable because inflammatory myositis occurred alongside <em>C. difficile</em> infection, raising the question of whether the infection acted as a trigger or contributed to unusually rapid disease progression. The report highlights the importance of early recognition of inflammatory myositis, especially in patients with unexplained rhabdomyolysis and weakness, as prompt diagnosis and treatment are essential to improving outcomes and reducing mortality.

Asset Subtitle

Alba L. Caceres Munoz

Meta Tag

Author List Alba L. Caceres Munoz, Anunaya Aashish, Kishan Talagadadeevi, Sophia Dhanani, Victor Adenuga, Yash Bhavsar

Category Clinical Vignettes

Concept Idiopathic Inflammatory Myositis

Concept Severe Weakness

Concept Rhabdomyolysis

Concept Respiratory Muscle Weakness

Concept Respiratory Failure

Distinguished Non-Finalist

Presenter Organization Texas Health Resources HEB/ Denton

Presenting Author Alba L. Caceres Munoz

Track Adult

Keywords

inflammatory myositis

Clostridium difficile

rhabdomyolysis

creatine kinase

generalized weakness

acute kidney injury

anti-JO-1

respiratory failure

septic shock

diaphragmatic dysfunction

Idiopathic Inflammatory Myositis

Severe Weakness

Rhabdomyolysis

Respiratory Muscle Weakness

Respiratory Failure