Abstract
Our 43-years-old patient was diagnosed with pleural tuberculosis. Biological tests were ordered prior to the onset of the treatment and were all normal. After one month under treatment, he developed hematological and hepatic toxicity signs: neutropenia, cytolysis and cholestasis. After an onward investigation, rifampicin was identified as neutropenia causal treatment and pyrazinamide was avoided to prevent its hepatotoxicity. The decision of the multidisciplinary staff was to introduce a combination of three drugs: Isoniazid, Ethambutol and Ciprofloxacin for eight months while stopping Rifampicin. Chest X ray exam showed no recurrence of the pleural effusion.
Highlights
Adverse effects under anti tuberculosis treatment (ATT) are various, some of them are frequent and some others may become life threatening.When they occur, the first challenge is to identify the causal agent among the association of ATT
We report a case of leukopenia induced by an anti-tuberculosis oral treatment
To restore a second therapeutic protocol with fewer risks of side effects, quinolones may provide a better option than aminosides
Summary
Adverse effects under anti tuberculosis treatment (ATT) are various, some of them are frequent and some others may become life threatening. When they occur, the first challenge is to identify the causal agent among the association of ATT. Drug susceptibility test was performed for major anti TB medicines: Rifampicin, isoniazid, Ethambutol and Pyrazinamide. Blood tests were checked repeatedly every week until they normalized (20 days later) He was put on a non-hepatotoxic background regimen while stopping Pyrazinamide. The decision of the multidisciplinary staff was to introduce a combination of three drugs: Isoniazid, Ethambutol and Ciprofloxacin for a duration of eight months while stopping Rifampicin. Chest X-ray exam showed no recurrence of the pleural effusion
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