A 57-Year-Old Male Retired Colonel with Acute Ankle Swelling

In 2004, a 57-year-old retired Army Colonel experienced acute swelling and pain in both ankles, which worsened with dorsiflexion and weight bearing. His medical history was notable for several conditions, including prostatitis and hypertension, and he was taking multiple medications, one of which was levofloxacin. Initial diagnoses considered were various forms of arthritis and systemic rheumatic diseases. However, tests, including synovial fluid analysis, concluded that his condition was levofloxacin-induced bilateral Achilles tendonitis. Treatment involved stopping levofloxacin and administering nonsteroidal anti-inflammatory drugs and rest. This case underscored the need to consider fluoroquinolone-associated tendonitis in patients with tendonitis symptoms who are taking or have recently finished a course of fluoroquinolone antibiotics.