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Related Experiment Videos

Meningitis or madness: a delicate balance.

T Duke1, M Mai

  • 1Department of Paediatrics, Goroka Base Hospital, Papua New Guinea. duke@global.net.pg

Journal of Paediatrics and Child Health
|July 15, 1999
PubMed
Summary

This case study details a child experiencing psychosis linked to isoniazid treatment for tuberculous meningitis. Adjusting the isoniazid dosage schedule successfully managed both conditions, marking the first reported instance in a child.

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Area of Science:

  • Pediatric Neurology
  • Infectious Diseases
  • Psychiatry

Background:

  • Tuberculous meningitis (TBM) is a serious infection requiring prolonged antimicrobial therapy.
  • Isoniazid is a cornerstone medication for treating tuberculosis, including TBM.
  • Adverse drug reactions in children treated for TBM require careful monitoring.

Observation:

  • A pediatric patient treated for TBM developed psychosis approximately two weeks after initiating antitubercular therapy.
  • Psychotic symptoms resolved upon discontinuation of isoniazid but recurred with its reintroduction.
  • The patient's meningitis recurred when isoniazid was stopped, necessitating careful management.

Findings:

  • Intermittent dosing of isoniazid (every 48 hours) allowed for successful TBM treatment with minimal psychotic symptoms.
  • Complete resolution of psychosis occurred after finishing TBM therapy and stopping isoniazid.
  • This is the first reported case of isoniazid-associated psychosis in a pediatric patient.

Implications:

  • Highlights the potential for isoniazid-induced psychosis in children with TBM.
  • Suggests that altered dosing schedules may mitigate neuropsychiatric side effects.
  • Emphasizes the importance of vigilant psychiatric monitoring during antitubercular treatment in pediatric populations.

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