A 72-year-old patient presents with a burning sensation and metallic taste. The patient has sinusitis and has taken levofloxacin for two weeks. Medications include metoprolol and levofloxacin. What is the most likely reason for the symptoms?

Correct answer: A. Medication

• A. CORRECT. Both metoprolol and many systemic antibiotics are documented causes of dysgeusia (altered or metallic taste) and burning sensations. The temporal link to recent drug use points to a medication side effect.
• B. INCORRECT. Idiopathic is a diagnosis of exclusion. Here a clear drug history offers a plausible cause, so it is not idiopathic.
• C. INCORRECT. Candidiasis usually shows white wipeable plaques or erythema and is not described in this case.
• D. INCORRECT. Xerostomia can alter taste, but the burning plus metallic taste with a fresh drug history fits a direct medication effect better.