Case reportPulmonary Embolism Associated with Spontaneous Bilateral Achilles Tendon Rupture
Section snippets
Case Report
A 69-year-old man with a history of chronic obstructive pulmonary disease (COPD), asthma, and obstructive sleep apnea was admitted to the hospital for treatment of an acute exacerbation of his COPD. While in-house, he received intravenous corticosteroids and nebulizer treatments. He was discharged on a 60-mg tapered regimen of prednisone and a 10-day course of levofloxacin. Over the next 2 weeks, he developed bilateral posterior heel pain, and on day 17 after the exacerbation of his COPD, he
Discussion
Spontaneous tears account for about 1% of all Achilles tendon ruptures (9, 11) and are associated with an array of intrinsic and extrinsic risk factors. Intrinsic risk factors include prior trauma and degenerative changes of the tendon, and systemic disorders such as Cushing’s disease, rheumatoid arthritis (17), systemic lupus erythromatosus (18), hyperthyroidism, and gout. Extrinsic risk factors include pharmacologic agents such as corticosteroids (7, 9, 14, 19, 20, 21, 22) and
Conclusion
Bilateral Achilles tendon ruptures are rare and usually occur in patients with chronic disease, and many of these cases are associated with corticosteroid or fluoroquinolone use. Nonoperative treatment is generally effective for this population, and, despite eliminating risks associated with surgical repair of the tendon, immobilization therapy conveys the risk of developing DVT and pulmonary embolism. In the case of simultaneous, bilateral rupture of the Achilles tendon, the risk of DVT and
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Cited by (9)
Musculoskeletal Complications of Fluoroquinolones: Guidelines and Precautions for Usage in the Athletic Population
2011, PM and RCitation Excerpt :Subsequent to these initial reports, multiple cases of fluoroquinolone-associated tendinopathy have been published. Among reported cases, the Achilles tendon is most commonly involved [3,4,7,11,13,27-58]. However, multiple other tendons and tendon groups have been involved, including the common extensor tendon origin of the lateral elbow [59], subscapularis [55], biceps brachii [41], brachioradialis [40], adductor longus [60], plantar foot tendons [61], rectus femoris [62], flexor hallucis longus [63], supraspinatus, extensor pollicis longus, quadriceps, and patellar [3], and the tendons of the extraocular muscles [64].
Incidence of Achilles tendon rupture: 25-year regional analysis with a focus on bilateral ruptures
2023, Journal of International Medical ResearchBilateral Levofloxacin-Induced Achilles Tendon Rupture: An Uncommon Case Report and Review of the Literature
2019, Clinical Medicine Insights: Arthritis and Musculoskeletal DisordersSudden death due to pulmonary embolism after minor ankle surgery
2019, BMJ Case ReportsFatal pulmonary thromboembolism after Achilles tendon open repair: A rare case report
2017, Medicine (United States)