Quinolones and Tendon Ruptures

J. Michael Casparian, MD, Michael Luchi, MD, Department of Medicine, Divisions of Dermatology and Infectious Diseases, University of Kansas Medical Center, Kansas City, Kan; Robert E. Moffat, MD, Department of Radiology, Shawnee Mission Medical Center, Merriam, Kan; Daniel Hinthorn, MD, Department of Medicine, Divisions of Dermatology and Infectious Diseases, University of Kansas Medical Center, Kansas City, Kan

South Med J. 2000;93(5) 

In This Article

Case Reports

Case 1. A 38-year-old physician was involved in a motor vehicle accident resulting in vertebral and rib fractures, as well as bilateral hemopneumothoraces. After a 3-week admission, he was discharged on a 1-week course of ciprofloxacin (500 mg twice daily) because of a productive cough. The patient had no symptoms related to his legs until 6 months after discharge. At that time, he had sudden, severe pain while taking a short walk. Physical examination was consistent with a complete rupture of the Achilles tendon. He subsequently had surgical repair of the rupture, with an uneventful postoperative course.

Case 2. A 54-year-old physician was given a 10-week course of ciprofloxacin (500 mg bid) for recurrent bacterial prostatitis. Two months into the course, he had marked right anterior shoulder pain associated with vertical "push-ups" done against a wall for the purpose of calf muscle stretching. Cessation of the activity and use of nonsteroidal anti-inflammatory drugs (NSAIDs) did not relieve the symptoms. Magnetic resonance imaging (MRI) of the right shoulder showed a partial tear of the subscapularis tendon (Figure). Discontinuing ciprofloxacin, along with starting physical therapy and NSAIDs, completely resolved the patient's symptoms in 5 weeks.

Figure.

Transaxial image of right shoulder shows thickening and increased signal in subscapularis tendon (arrows).

Comments

3090D553-9492-4563-8681-AD288FA52ACE
Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
Post as:

processing....