A 40-year-old man presented to our hospital with a transient loss of consciousness after heroin consumption.
He had swelling of both left extremities, with abolition of motility and decreased sensitivity of the left lower limb, absence of pedal pulse with persistence of radial and ulnar pulses.
On admission laboratory analysis showed: CPK: 151,650 IU/l, GOT: 702 IU/l, GPT: 489 IU/l, creatinine: 4.1 mg/dl and potassium: 5.1 mmol/l.
The patient was admitted to the operating room due to mental retardation with rabiesolysis and secondary ARI. Fasciotomies were performed on the left limbs.
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From the beginning, diuresis is tried with dopamine at pre-ß doses, perfusion of furosemide at 0.1 mg/kg/h and mannitol at 0.5 g/kg. At the third day, there is an increase in serum creatinine 8.
Renal function is progressively recovering with creatinine at discharge from the intensive care unit of 3.5 mg/dl and spontaneous diuresis of 3900 cc/24h.
The patient developed permanent sensory-motor impairment of the left foot as a sequel, with limitation of the flexor-extensive motility of the fingers and global hypoesthetic-paresis sensitivity.
