Vigilance Needed in Treating a Child with Disseminated TB: A Case Report

Hemasri      Velmurugan; Krishnapriya      Neelambaram; Meenalotchini   Prakash   Gurunthalingam; Dushyant      Chouhan; Pugazhenthan      Thangaraju; Bikram      Keshari Kar; Nitin   Rewaram   Gaikwad

doi:10.2174/0118715265287146240405075930

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Abstract

Background: Tuberculosis is still one of the biggest causes of infection-related death around the world. Disseminated tuberculosis is a potentially fatal disease caused by the haematogenous spread of Mycobacterium tuberculosis. First-line anti-tuberculosis drugs in-clude isoniazid, rifampicin, pyrazinamide, and ethambutol. The first three drugs are known to cause hepatotoxicity.

Case Presentation: We have, herein, reported a case of Drug-induced Liver Injury (DILI) due to anti-tuberculosis therapy in a one-year-old male child with disseminated tuberculosis. He was started on a fixed-dose combination of Anti-tuberculosis Therapy (ATT; isoniazid 50 mg, rifampicin 75 mg, and pyrazinamide 150 mg) and pyridoxine 10 mg orally. Initially, liver pa-rameters were normal, but later on with the course of the treatment, there was a rapid rise in liver enzymes, suggesting liver injury.

Discussion: The association between liver injury and anti-tuberculosis therapy has been con-firmed by applying various causality association scales. It is obvious that proper treatment of disseminated tuberculosis can avoid the development of drug-resistant strains that can be harm-ful, worsening the prognosis as there are fewer therapeutic alternatives available. At the same time, there is a need to monitor the patient with ATT-induced DILI.

Conclusion: The diagnosis of tuberculosis in children is difficult because of the mild, nonspe-cific clinical presentation, which usually reflects the implicated underlying organ. In addition to prompt diagnosis and treatment of disseminated TB, careful monitoring is equally important.

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DOI https://dx.doi.org/10.2174/0118715265287146240405075930	Print ISSN 1871-5265
Publisher Name Bentham Science Publisher	Online ISSN 2212-3989

Infectious Disorders - Drug Targets

Vigilance Needed in Treating a Child with Disseminated TB: A Case Report

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