He reported severe pain in both extremities that was worse in the lower legs. ![]() 6 While there have been many reported cases of cocaine abuse resulting in rhabdomyolysis, our paper identifies a further complication of compartment syndrome that is not frequently encountered.Ī 44-year-old male with a past medical history of polysubstance abuse presented to the ED by EMS transport with bilateral lower extremity pain. 5 Additionally, Huson and Fontenot reported a case of non-traumatic compartment syndrome associated with cocaine use, but they ultimately suspected multiple contributing factors including prolonged creatine usage and strenuous exercise. However, this patient only developed isolated anterior upper extremity compartment syndrome near the injection site. described a case of substance abuse-associated compartment syndrome secondary to intravenous injection of cocaine and heroin. 3,4 However, compartment syndrome due to cocaine-induced rhabdomyolysis is rare or underreported. 1,2 Additionally, non-traumatic rhabdomyolysis, usually due to strenuous exercise, has been reported as a rare cause of compartment syndrome without significant trauma. Rhabdomyolysis due to substance use, especially cocaine, is a well-documented occurrence. We present a case of compartment syndrome likely due to substance-induced rhabdomyolysis. Rapid recognition of this uncommon condition is important as urgent fasciotomy is the mainstay treatment. Although substance-induced rhabdomyolysis has been widely reported, the progression to compartment syndrome is not frequently encountered and usually of multifactorial etiology. ![]() Ultimately, his cocaine usage was the only identifiable etiology of his presentation. The patient required bilateral four-compartment fasciotomy, ICU admission, and temporary hemodialysis. We report on a 44-year-old male who presented to the ED with bilateral lower extremity compartment syndrome likely secondary to cocaine-induced rhabdomyolysis. Acute non-traumatic rhabdomyolysis and compartment syndrome is a rare condition not frequently reported in the literature.
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