Fluoroquinolones
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Tendon injuries: 2 case reports Two women, who had undergone kidney transplantation, developed tendon injuries during treatment with fluoroquinolones for urinary tract infections. A 54-year-old woman, who had undergone double kidney transplantation and received immunosuppressive therapy, started receiving a 10-day course of ciprofloxacin 500mg twice daily 6 months after transplantation. Two weeks later, 5 days after completion of ciprofloxacin treatment, she reported oedema, joint pain and difficulties with deambulation at rest and standing up. Physical examination revealed hypotrophismnormostenism of her calf, bilateral perimalleolar oedema and hyperreflexis of both of her arms and legs with myoclones. Peripheral neuropathy was excluded by electromyography results. Foot x-ray and ultrasonography revealed the presence of calcaneal thorns and evidence of bilateral perimalleolar insertional tendinopathy. She underwent physical therapy for 1 month and her symptoms resolved. However, 1 month later, she developed similar symptoms during a second 5-day course of fluoroquinolones [specific drug, dosage and time to reaction onset not stated] for recurrent urinary tract infection. The fluoroquinolone was immediately stopped and, after 2 months of rest, her symptoms completely resolved. A 60-year-old woman, who had undergone kidney transplantation in 2002 and had received immunosuppressive therapy, started receiving ciprofloxacin [dosage and duration of treatment not stated]. During the course, she experienced left Achilles tendon pain with local oedema and difficulty with ambulation or standing up [time to reaction onset not clearly stated]. Ultrasonography showed evidence of perimalleolar insertional tendinopathy. After 1 month, her controlateral tendon developed the same symptoms and, after 2 months, both tendons spontaneously ruptured. She underwent bilateral tenorrhaphy and postoperative physical therapy and her symptoms resolved. Muzi F, et al. Fluoroquinolones-induced tendinitis and tendon rupture in kidney transplant recipients: 2 cases and a review of the literature. Transplantation 801071846 Proceedings 39: 1673-1675, No. 5, Jun 2007 - Italy
0114-9954/10/1159-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Reactions 7 Jul 2007 No. 1159
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