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Ciprofloxacin-Induced Peripheral Neuropathy: A Case Report
Alexander Refaeian1, Eric L Vest2, Michael Schmidt3
1Texas Christian University Burnett School of Medicine, Fort Worth, TX.
Introduction:
Fluoroquinolones, a class of antibiotics, are commonly employed in the treatment of a wide array of bacterial infections. Recognized for their effectiveness against a broad spectrum of pathogens, fluoroquinolones have played a pivotal role in managing conditions like urinary tract infections and respiratory diseases. Nevertheless, their usage is not without contention due to their association with a variety of adverse effects, including tendon rupture and the less frequently reported issue of peripheral neuropathy.
Case Presentation:
We present the case of a 42-year-old male who developed peripheral neuropathy several days after completing a 10-day course of ciprofloxacin for gastroenteritis. The patient's presenting complaint was bilateral upper and lower extremity weakness for which inpatient treatment was initiated and workup for other causes was negative. Nerve conduction studies (NCS) and electromyography (EMG) demonstrated peripheral neuropathy. The patient was treated with intravenous immunoglobulin (IVIG), steroids, and physical therapy. Followup NCS and EMG showed continued neuropathy but with significant improvement.
Conclusion:
The case aligns with existing research, demonstrating that fluoroquinolone use is linked to peripheral neuropathy, particularly axonal polyneuropathy, and emphasizes the importance of investigating the underlying mechanism for improved therapeutic strategies. The potential combination of intravenous immunoglobulin and physical therapy has exhibited promising results.
Insights
Fluoroquinolone antibiotics can cause peripheral neuropathy, a nerve disorder. Early treatment with IVIG and physical therapy shows promise for improving patient outcomes.
Area of Science:
- Neurology
- Pharmacology
Background:
- Fluoroquinolones are broad-spectrum antibiotics frequently used for bacterial infections.
- Adverse effects include tendon rupture and peripheral neuropathy.
Observation:
- A 42-year-old male developed peripheral neuropathy after ciprofloxacin treatment for gastroenteritis.
- Symptoms included bilateral upper and lower extremity weakness.
Findings:
- Nerve conduction studies and EMG confirmed peripheral neuropathy.
- Treatment with IVIG, steroids, and physical therapy led to significant improvement.
Implications:
- Fluoroquinolone-associated peripheral neuropathy, particularly axonal polyneuropathy, requires further mechanistic investigation.
- Combination therapy with IVIG and physical therapy shows therapeutic potential.
