Muscular Involvement in Dengue Fever: Clinical Spectrum and Pathophysiological Mechanisms

Authors

Abstract

Objective: To determine the prevalence and clinical characteristics of muscular involvement in dengue infection, including myalgia, myositis, rhabdomyolysis, and hypokalaemic paralysis, by evaluating clinical presentations and laboratory parameters—particularly creatine phosphokinase (CPK) levels—in patients presenting to the outpatient department and those admitted to the dengue ward.

Methods

We conducted a prospective descriptive study including 75 patients with confirmed dengue fever. Demographic, clinical, and biochemical data were collected. Muscular involvement was classified as myalgia, myositis, rhabdomyolysis, or hypokalemic paralysis. Creatine phosphokinase (CPK) levels and other laboratory parameters were recorded. Associations were assessed using chi-square/Fisher's exact tests, Mann–Whitney U test, and odds ratios with 95% confidence intervals.

Results

 The mean age of participants was 36.8 ± 16.5 years; 70.7% were male. Elevated CPK was observed in 48.0% of patients. Rhabdomyolysis occurred exclusively in those with elevated CPK (22.2% vs. 0.0%; Fisher's exact p = 0.0018; OR = 22.3, 95% CI 1.23–404.2). Muscle weakness was significantly more common in patients with elevated CPK (44.4% vs. 5.1%; χ² = 13.78, p < 0.001; OR = 14.8, 95% CI 3.09–70.95). No significant association was found between CPK status and self-reported muscle pain (p = 0.968). No participants exhibited electrolyte imbalance.

Conclusion

 Muscular complications, including rhabdomyolysis and weakness, are significantly associated with elevated CPK in dengue fever. Routine CPK monitoring may help in early detection of severe muscular involvement. Larger, multicenter studies are warranted.

Keywords:

Dengue Fever; Myositis; Rhabdomyolysis; Creatinine Phosphokinase.

Published

2026/08/22

Issue

Vol. Volume 7-issue 3

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