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Journal of Orthopaedics and Traumatology : Official Journal of the Italian Society of Orthopaedics and Traumatology logoLink to Journal of Orthopaedics and Traumatology : Official Journal of the Italian Society of Orthopaedics and Traumatology
. 2007 Jun 8;8(2):86–90. doi: 10.1007/s10195-007-0168-7

Spontaneous bilateral Achilles tendon rupture in a patient treated with oral levofloxacin

A E Salvi 1,✉, G P Metelli 1, A Bosco 2, A Berizzi 3, S A Hacking 4, A Cantalamessa 5
PMCID: PMC4484540  PMID: 27519893

Abstract

A case of bilateral rupture of the Achilles tendon in a patient treated with levofloxacin for cystitis is reported. A 76-year-old woman suddenly developed painful ankles one day after levofloxacin treatment. Drug therapy was switched to amoxicillin/clavulanate on the fourth day. Sonography revealed a serious condition of tendinosis with complete bilateral full-thickness rupture on day 6. Tendons were both repaired in the same surgical session. Pathological anatomy of the specimens reported fatty tissue lobules with panniculitis and histiocytosis. Ankles were immobilized postoperatively with a plaster cast. Achilles tendon rupture may occur as an adverse side effect of short-term use of levofloxacin, a fluoroquinolone antibiotic. This adverse effect is a rare and poorly understood complication of this antibiotic therapy. A review of the literature is provided.

Key words: Fluoroquinolone, Levofloxacin, Antibiotic, Achilles tendon, Tendon rupture, Tendinosis, Cystitis

Footnotes

An erratum to this article is available at http://dx.doi.org/10.1007/s10195-007-0077-9.

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