Spontaneous Four Limb Compartment Syndrome

We present a unique case of atraumatic rhabdomyolysis and four-limb compartment syndrome. Edema and inflammation associated with rhabdomyolysis, was further exacerbated by aggressive saline resuscitation. This resulted in raised compartment pressures and necessitated four-limb fasciotomy. The cause of rhabdomyolysis was most likely multifactorial including systemic capillary leak syndrome seizure, illicit drug use (crack cocaine and methamphetamine) and the prescription medication, mirtazapine.