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Rupture of adductor longus tendon due to ciprofloxacin

George Mouzopoulos1, Mihalis Stamatakos, George Vasiliadis

  • 1Sparta Hospital, Sparta and Laiko Hospital, Athens, Greece. gmouzopoulos@yahoo.gr

Acta Orthopaedica Belgica
|February 8, 2006
PubMed

Insights

Ciprofloxacin, an antibiotic, rarely causes spontaneous adductor longus tendon rupture. This case highlights the importance of recognizing this adverse effect for prompt diagnosis and management of fluoroquinolone-induced tendon injuries.

Area of Science:

  • Orthopedics
  • Pharmacology
  • Sports Medicine

Background:

  • Fluoroquinolones are broad-spectrum antibiotics with known associations with tendon pathologies.
  • Tendon rupture is a rare but serious adverse effect of fluoroquinolone therapy.

Observation:

  • A 35-year-old male developed left medial thigh discomfort, pain, and swelling after initiating ciprofloxacin for pneumonia.
  • A palpable mass was noted, and MRI confirmed spontaneous adductor longus tendon rupture.
  • No other predisposing factors for tendon rupture were identified.

Findings:

  • The patient's adductor longus tendon rupture was directly linked to ciprofloxacin administration.
  • Pathophysiological mechanisms of fluoroquinolone-related tendon rupture involve disruption of tenocyte function and extracellular matrix.
  • Risk factors include age, renal impairment, and concurrent corticosteroid use.

Implications:

  • Clinicians should maintain a high index of suspicion for tendon rupture in patients on fluoroquinolones, especially with localized pain or swelling.
  • Early recognition and appropriate management are crucial to prevent long-term morbidity.
  • Further research into preventative strategies and risk stratification for fluoroquinolone-induced tendinopathy is warranted.

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