Finsterer Josef, Stollberger C Claudia, Melichart-Kotig Madleine
Klinik Landstrasse, Messerli Institute, Vienna, Austria.
2nd Medical Department, Klinik Landstrasse, Vienna, Austria.
J Family Med Prim Care. 2022 May;11(5):2211-2213. doi: 10.4103/jfmpc.jfmpc_452_21. Epub 2022 May 14.
A 17-year-old male with uneventful previous history developed generalized myalgias, exercise intolerance, and general fatigue after two dosages of azithromycin (500 mg/d) during 3 d for febrile infection. Neurologic exam revealed generally reduced tendon reflexes. Serum creatine kinase (CK) was elevated to 25000 U/L. Needle-EMG showed short and small, polyphasic motor-units and abnormal spontaneous activity, being interpreted as myositis. Azithromycin was discontinued and he was advised to avoid the fitness studio and to drink plenty of liquids. Myalgias disappeared within two days and CK continuously declined. Azithromycin may trigger rhabdomyolysis in the context of exercise and infection. Azithromycin may be myotoxic and should be prescribed with caution in exercising and infected patients.
一名17岁男性，既往史无异常，因发热性感染在3天内分两次服用阿奇霉素（500毫克/天）后出现全身肌痛、运动不耐受和全身疲劳。神经系统检查显示腱反射普遍减弱。血清肌酸激酶（CK）升高至25000 U/L。针极肌电图显示运动单位短小、多相且有异常自发电活动，被解释为肌炎。停用阿奇霉素，并建议他避免去健身工作室，多喝水。肌痛在两天内消失，CK持续下降。阿奇霉素在运动和感染的情况下可能引发横纹肌溶解。阿奇霉素可能具有肌毒性，在运动和感染的患者中应谨慎使用。
