Encephalopathy caused by isoniazid in a patient with end stage renal disease with extrapulmonary tuberculosis

Tuberculosis infection is common in patients on maintenance hemodialysis, and the extrapulmonary presentations, which is usually asymptomatic, and only mild clinical presentation, are not uncommon. These hemodialysis patients were always prescribed multiple antituberculosis agents, including isoniazid, rifampin, ethambutol, and pyrazinamide, alongside their usual medication. Conscious disturbance was also frequently observed in these patients, with different paramount etiologies in the pre- and post-hemodialysis phases. We report a case undergoing maintenance hemodialysis, showing disturbed consciousness ten days following antituberculosis treatment for his established extrapulmonary tuberculosis infection. Consciousness was regained seven days later, after discontinuation of isoniazid.