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Bilateral Levofloxacin-Induced Achilles Tendon Rupture: An Uncommon Case Report and Review of the Literature

Marcos Edgar Fernández-Cuadros1,2, Luz Otilia Casique-Bocanegra3, María Jesús Albaladejo-Florín1

  • 1Physical Medicine and Rehabilitation Department, Hospital Universitario Santa Cristina, Madrid, Spain.

Clinical Medicine Insights. Arthritis and Musculoskeletal Disorders
|March 13, 2019
PubMed

Insights

Fluoroquinolones (FQ) antibiotics can cause Achilles tendon rupture, a rare but serious side effect. This case report highlights the diagnostic challenges of this debilitating condition in an elderly patient.

Area of Science:

  • Pharmacology
  • Orthopedics
  • Infectious Diseases

Background:

  • Fluoroquinolones (FQ) are widely used for bacterial infections due to favorable pharmacokinetic properties.
  • Adverse effects, including tendinopathy and tendon rupture, have been reported with FQ use.
  • FQ-induced tendinopathy was first documented in 1983, with over 100 cases published since.

Observation:

  • This case report details a challenging diagnosis of bilateral Achilles tendon rupture in an elderly patient.
  • The presentation was uncommon, necessitating a thorough review of existing literature.
  • Most reported rupture cases are associated with concurrent corticosteroid use and underlying rheumatic, vascular, or renal diseases.

Findings:

  • Fluoroquinolone (FQ) antibiotics are associated with a risk of tendinopathy and tendon rupture.
  • These adverse events can manifest from hours after initiation to months after discontinuation of FQ.
  • Bilateral Achilles tendon rupture is a rare but severe complication, with limited reported cases globally.

Implications:

  • Recognizing the potential for FQ-induced tendon rupture is crucial for timely diagnosis and management.
  • Physicians should consider FQ as a potential causative agent in patients presenting with tendon pathologies, especially the elderly.
  • Further research may elucidate the precise mechanisms and risk factors for FQ-induced tendon rupture to improve patient safety.
Keywords:
Fluoroquinolonesachilles tendonrupturetendinopathy

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