J Korean Foot Ankle Soc.  2023 Sep;27(3):103-107. 10.14193/jkfas.2023.27.3.103.

Refractory Achilles Tendinopathy and Multiple Pain on the Tendon and Tendon Attachment Site of the Foot Related to Intermittent Levofloxacin Usage: A Case Report

• Park SJ
• Suh JS
• Choi JY

• KMID: 2545989
• DOI: http://doi.org/10.14193/jkfas.2023.27.3.103

Abstract

Quinolone antibiotics are frequently prescribed for suspected respiratory or urinary tract infections because of their effectiveness and generally perceived safety profile. On the other hand, some studies have raised concerns regarding the potential association between quinolone use and Achilles tendinopathy or tendon rupture. There is a lack of reports on the link between quinolone use and multiple tendon and tendon attachment site pain in the foot and ankle joints; hence, this study examined this issue further. This paper presents a case report of a patient with persistent Achilles tendinopathy and multiple tendon and tendon attachment site pain in the foot who did not respond adequately to conservative treatments. In particular, the discontinuation of quinolone use resulted in favorable clinical outcomes. This report offers valuable insights into the potential risks associated with quinolone antibiotics and highlights the importance of vigilance when managing patients with tendon-related complaints. A comprehensive review of the relevant literature is also presented to contextualize these findings.

Keyword

Achilles tendinopathy; Enthesopathy; Tendinitis; Levofloxacin; Adverse reaction

Figure

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  Figure 1 Standing foot anteroposterior (A), left lateral (B), right lateral (C), and hindfoot alignment (D) radiographs showed no specific abnormal findings.

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  Figure 2 On left ankle magnetic resonance imaging, Achilles tendon continuity was intact with no specific signal changes on calcaneus while the timid signal change was detected in Achilles tendon itself.

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