Hepatitis in patients with surgical complications of pulmonary tuberculosis

During last six years, 2250 patients were treated in Cardiothoracic Unit for thoracic complications of pulmonary tuberculosis. During isoniazid/streptomycin/ethambutol treatment, 2 patients out of 710 (0.28%) developed hepatitis. During isoniazid/rifampicin/ethambutol therapy, 18 patients out of 1540 (1.17%) suffered from jaundice; all these patients were above 30 years of age, and many had gross anemia (Hb less than 9 gm%), hypoalbuminemia (less than 3 gm%) and radiologically far-advanced disease in comparison to those who did not develop jaundice (p less than 0.05). Jaundice subsided completely after discontinuation of isoniazid and/or rifampicin which were re-instituted successfully after recovery without recurrence of hepatitis. It is suggested that the development of hepatitis does not warrant total withdrawal of these two highly effective bactericidal drugs but they should be tried again cautiously after recovery from jaundice.