Ciprofloxacin is increasingly used as oral suppressive therapy for musculoskeletal infections. Delirium and acute hypoglycemia are little-known, severe potential adverse drug reactions. We report here on a patient who experienced both complications. The patient is a 56-year-old woman with no psychiatric history who was managed for left lower extremity chronic osteomyelitis after fracture fixation. She developed significant, prolonged delirium and intermittent hypoglycemia within 24 hours of starting ciprofloxacin; both symptoms remitted within 24 hours of drug discontinuation.
The neuropsychiatric complications of ciprofloxacin are under-discussed, given its frequency of use, and merit greater awareness for the prevention of postoperative delirium.