A 17yo male marriage with uneventful previous history developed
generalised myalgias, exercise intolerance, and general fatigue after
two dosages of azithromycin (500mg/d) during 3d for febrile infection.
Neurologic exam revealed generally reduced tendon reflexes. Serum
creatine-kinase was elevated to 25000U/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 why it should be prescribed with
caution in exercising and infected patients.