Cocaine-Induced Rhabdomyolysis With Acute Kidney Injury in the Absence of Serotonin Syndrome: A Case Report

Rhabdomyolysis is a clinical condition resulting from skeletal muscle breakdown, leading to the release of intracellular components, such as creatine kinase, myoglobin, and electrolytes, into the circulation. This process can cause a range of complications, most notably acute kidney injury (AKI), due to myoglobin-induced renal toxicity. While trauma, seizures, and hyperthermia are well-known precipitants, stimulant drugs represent an underrecognized yet clinically significant cause. This report describes a middle-aged patient who presented with marked rhabdomyolysis and acute kidney injury (AKI) following intranasal use of cocaine. Notably, the patient exhibited no features of serotonin syndrome despite concurrent use of an antidepressant medication. Laboratory investigations revealed markedly elevated creatine kinase levels, while prompt intravenous fluid resuscitation resulted in complete renal recovery without the need for dialysis. This case highlights the diagnostic importance of considering stimulant-induced muscle injury in patients presenting with unexplained rhabdomyolysis and renal dysfunction, particularly when typical precipitating factors are absent. Early recognition and aggressive hydration remain key management strategies to prevent irreversible renal damage and improve outcomes.