Chikungunya-associated rhabdomyolysis: a case series of three patients from Sri Lanka

Abstract Background Chikungunya virus (CHIKV) is an arbovirus causing febrile illness with musculoskeletal symptoms. Although self-limiting, Chikungunya can result in rhabdomyolysis, with the risk of acute kidney injury. Methods We report three elderly men with comorbidities who developed rhabdomyolysis during the 2025 outbreak. Results Clinical features included fever, myalgia, confusion, quadriplegia and muscle oedema; creatine phosphokinase (CPK) ranged from 1105 to 46810 U/L. RT-PCR confirmed CHIKV in two cases. All were managed with intravenous fluids and renal and electrolyte monitoring, with variable recovery. Conclusions Rhabdomyolysis is under-recognized; clinicians should maintain high suspicion in older patients with comorbidities, monitor CPK and treat promptly.