Drug-Induced Liver Injury from Anti-Tuberculosis Treatment in a Case of TB Meningitis

Abstract

This case study revolves around a 38-year-old male patient who arrived at the Emergency department complaining of decreased levels of consciousness, agitation, and disorientation. The case follows his admittance to the ICU, while a team of doctors worked on finding a possible diagnosis for his condition.
 It was later in the course of his disease that it was found from his CSF(Cerebrospinal fluid) sample that he was suffering from tuberculous meningitis. The culture result revealed a strain of Mycobacterium Tuberculosis that was sensitive to all the major anti-tuberculous drugs. This was a favorable point for the prognosis of this patient. Once he was started on a regimen of selected anti-TB drugs, his symptoms improved to the point of successful discharge from the hospital.
 However, a few days later, the patient again started experiencing symptoms that were serious enough to justify hospital admission. It was found that it was not any primary issue causing the symptoms this time, but rather the toxicity of the anti-tuberculous drugs. However, due to timely diagnosis, intervention, and management, his condition was managed effectively and he was discharged once again.
 This case study aims to measure the importance of prescribing the most effective yet adequate treatment regimen for all patients, keeping in mind several overlooked yet highly important health-related factors that could either exacerbate or deteriorate pre-existing health concerns in a given patient. If the patient had been evaluated carefully for any underlying liver diseases or been given a short trial to see if he could withstand the high dose of anti-tuberculous drugs, he would not have faced such dreadful consequences, though they were managed quickly.
 Keywords: Cerebrospinal fluid, Mycobacterium Tuberculosis, liver diseases, anti-tuberculous drugs.