Abstract Details

Title “Myalgia and Rhabdomyolysis from Retained Shrapnel in a Young Caribbean Male: A Unique Report of Lead Poisoning from Gun Shot Wounds in Health Care Disparities”

Topic General Neurology

Presentation(s) P10 - Poster Session 10 (5:00 PM-6:00 PM)

Poster/Presentation
Number 2-005

Objective NA

Background Rhabdomyolysis is a potentially life-threatening syndrome characterized by the breakdown of skeletal muscle tissue. Common etiologies include trauma, exertion, infection, and toxins. One rare cause is chronic lead poisoning, such as in this case with retained bullet fragments. Lead, known to result in systemic toxicity, is known to potentiate muscle damage leading to rhabdomyolysis. Caribbean Healthcare faces limitations including insufficient healthcare professionals, inadequate infrastructure, geographical barriers, economic challenges as well as varying cultural beliefs that impact care access. This case presents a unique persistent myalgia and rhabdomyolysis secondary to chronic lead exposure from retained bullet shrapnel in a patient with limited healthcare resources.

Design/Methods NA

Results A 21-year-old male was transferred from his home country of Anguila with a remote history of a gunshot wound to the left leg two years prior with retained fragments. He had experienced recurrent generalized myalgia and increased creatine phosphokinase (CPK) levels whenever he was ill. He was undergoing CPK checks every six months, with levels exceeding 16,000 on his last assessment. Initial presentation included dark urine, back pain, and CK levels were above 48000 despite previous fluid resuscitation. Physical examination was remarkable for moderate pain and tenderness to palpation in bilateral lower extremity. The patient’s condition improved with supportive care, and lead levels normalized after surgical removal of foreign bodies.

Conclusions This case highlights the need for heightened clinical awareness of rare causes of myalgia and rhabdomyolysis, such as chronic lead poisoning, specifically in patients with retained metallic foreign bodies. Early recognition and appropriate management are critical to preventing permanent damage and improving outcomes, highlighting the importance of accessibility to healthcare resources. Economic barriers may further prevent patients from accessing necessary care. Low public awareness further limits early intervention opportunities. These factors contribute to poorer health outcomes for patients with rare presentations of diseases.

Authors/Disclosures
Oscar Pablo Mata, MD PRESENTER	Dr. Mata has nothing to disclose.
Cesar Jara Silva Acosta, DO (Larkin)	Dr. Jara Silva Acosta has nothing to disclose.
Marisol Trejos, MD (Larkin Community Hospital Palm Springs Campus)	Dr. Trejos has nothing to disclose.
Solomon Nittala, DO	Dr. Nittala has nothing to disclose.

��ɫ��

��ɫ��