title: Spontaneous bilateral Achilles tendon rupture in a patient treated with oral levofloxacin.
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.
authors: Orthopaedics and Traumatology Department, Mellino Mellini Hospital Trust Civil Hospital of Iseo, I-25049, Iseo (BS), Italy. andrea@orthopaedics.com.
authors: A E
authors: AE
authors: Salvi
authors: Orthopaedics and Traumatology Department, Mellino Mellini Hospital Trust Civil Hospital of Iseo, I-25049, Iseo (BS), Italy.
authors: G P
authors: GP
authors: Metelli
authors: Accident and Emergency Department Mellino Mellini Hospital Trust, Civil Hospital of Iseo, Iseo (BS), Italy.
authors: A
authors: A
authors: Bosco
authors: Orthopaedics and Traumatology Department, University of Padua, Padua, Italy.
authors: A
authors: A
authors: Berizzi
authors: Department of Orthopaedics JTN Wong Labs for Mineralized Tissue Research, McGill University, Montreal, Quebec, Canada.
authors: S A
authors: SA
authors: Hacking
authors: Department of Internal Medicine Mellino Mellini Hospital Trust, Civil Hospital of Iseo, Iseo (BS), Italy.
authors: A
authors: A
authors: Cantalamessa
keywords: Achilles tendon; Antibiotic; Cystitis; Fluoroquinolone; Levofloxacin; Tendinosis; Tendon rupture