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A man in the 70s was admitted to the hospital with bilateral thigh pain and difficulty walking following levofloxacin use. Creatine kinase levels were not elevated, but MRI revealed inflammation in the iliac and gluteal muscles. His symptoms improved after levofloxacin discontinuation, and he may have had levofloxacin-induced myopathy. This case report seeks to raise awareness of levofloxacin-induced myopathy by adding to the small number of reports in the literature. Levofloxacin-induced myopathy should be considered in the differential diagnosis when there are musculoskeletal symptoms in elderly patients receiving levofloxacin.<\/jats:p>","DOI":"10.1136\/bcr-2025-265915","type":"journal-article","created":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T08:30:18Z","timestamp":1761208218000},"page":"e265915","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Levofloxacin-induced myopathy of the iliac and gluteal muscles"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-5259-1924","authenticated-orcid":false,"given":"Yukiko","family":"Kato","sequence":"first","affiliation":[{"name":"General Internal Medicine, Aijinkai Takatsuki General Hospital, Takatsuki, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3299-5343","authenticated-orcid":false,"given":"Takahiko","family":"Tsutsumi","sequence":"additional","affiliation":[{"name":"Aijinkai Takatsuki General Hospital, Takatsuki, Osaka Prefecture, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,10,23]]},"reference":[{"key":"2025102301300586000_18.10.e265915.1","doi-asserted-by":"publisher","DOI":"10.2165\/00003495-200363240-00008"},{"key":"2025102301300586000_18.10.e265915.2","doi-asserted-by":"publisher","DOI":"10.1124\/mol.59.1.122"},{"key":"2025102301300586000_18.10.e265915.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijantimicag.2018.04.014"},{"key":"2025102301300586000_18.10.e265915.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmrj.2010.10.003"},{"key":"2025102301300586000_18.10.e265915.5","first-page":"358","article-title":"Drug-induced myopathies","volume":"67","author":"Mor","year":"2009","journal-title":"Bull NYU Hosp Jt Dis"},{"key":"2025102301300586000_18.10.e265915.6","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1186\/s13256-016-1004-6","article-title":"Levofloxacin-induced rhabdomyolysis: a case report","volume":"10","author":"John","year":"2016","journal-title":"J Med Case Rep"},{"key":"2025102301300586000_18.10.e265915.7","doi-asserted-by":"publisher","DOI":"10.1038\/clpt.1981.154"},{"key":"2025102301300586000_18.10.e265915.8","doi-asserted-by":"crossref","first-page":"14375","DOI":"10.1038\/s41598-021-93763-y","article-title":"A VigiBase descriptive study of fluoroquinolone induced disabling and potentially permanent musculoskeletal and connective tissue disorders","volume":"11","author":"Huruba","year":"2021","journal-title":"Sci Rep"},{"key":"2025102301300586000_18.10.e265915.9","doi-asserted-by":"crossref","first-page":"203","DOI":"10.2165\/00044011-200020030-00008","article-title":"A Case of Rhabdomyolysis due to Levofloxacin","volume":"20","author":"Nakamae","year":"2000","journal-title":"Clin Drug Investig"},{"key":"2025102301300586000_18.10.e265915.10","doi-asserted-by":"publisher","DOI":"10.1007\/s00228-003-0688-x"},{"key":"2025102301300586000_18.10.e265915.11","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfl396"},{"key":"2025102301300586000_18.10.e265915.12","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1111\/j.1542-4758.2011.00592.x","article-title":"Levofloxacin-induced rhabdomyolysis in a hemodialysis patient","volume":"16","author":"Gupta","year":"2012","journal-title":"Hemodial Int"},{"key":"2025102301300586000_18.10.e265915.13","doi-asserted-by":"crossref","DOI":"10.1155\/2014\/562929","article-title":"Acute rhabdomyolysis associated with coadministration of levofloxacin and simvastatin in a patient with normal renal function","volume":"2014","author":"Paparoupa","year":"2014","journal-title":"Case Rep Med"},{"key":"2025102301300586000_18.10.e265915.14","doi-asserted-by":"crossref","unstructured":"Jlal B , Galina B . 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