Emergency casebook
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We present a case series of two patients who presented to the emergency department with spontaneous bilateral Achilles tendon rupture associated with the use of ciprofloxacin. Tendinitis and tendon rupture are now well recognised but rare complications of treatment with Quinolone antimicrobials. The patients presented to the emergency department with symptoms suggestive of bilateral Achilles tendinitis leading to actual tendon rupture. The pathophysiology of quinolone-induced tendinopathy is still incompletely understood but well recognised risk factors include increasing age, renal failure and treatment with steroids. Age greater than 60 years has been associated with a three-fold increased relative risk of disease while concurrent steroid use in this elderly group is associated with a six-fold increased risk. The Committee for Safety of Medicines (CSM) remind us that care must be taken when prescribing Quinolones. These cases remind us that it is vitally important that emergency physicians ensure that Quinolone antibiotics are not
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Recreation/Sports injury
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