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Isoniazid-induced flu-like syndrome: A rare side effect
Sudipta Pandit1, Sabyasachi Choudhury, Anirban Das
1Department of Chest Medicine, Medical College, Kolkata, West Bengal, India.
Lung India : Official Organ of Indian Chest Society
|May 11, 2013
Summary
Isoniazid, a common tuberculosis drug, can rarely cause flu-like symptoms. A modified treatment replacing isoniazid with levofloxacin successfully treated a pediatric case of pulmonary tuberculosis.
Area of Science:
- Pulmonology
- Infectious Diseases
- Pharmacology
Background:
- Drug-induced flu-like syndrome is an uncommon adverse effect, predominantly associated with rifampicin.
- Pulmonary tuberculosis (PTB) treatment involves multi-drug regimens, increasing the risk of drug-induced side effects.
- Identifying specific drug culprits is crucial for managing adverse reactions in tuberculosis treatment.
Purpose of the Study:
- To report a rare case of isoniazid-induced flu-like syndrome in a pediatric patient with pulmonary tuberculosis.
- To highlight the diagnostic challenge and successful management of this adverse drug reaction.
- To emphasize the importance of considering isoniazid as a potential cause of flu-like symptoms during antitubercular therapy.
Main Methods:
- A 10-year-old girl diagnosed with PTB was initiated on standard first-line antitubercular therapy (ATT) including isoniazid, rifampicin, ethambutol, and pyrazinamide.
- The patient developed recurrent flu-like symptoms shortly after drug ingestion, prompting a diagnostic workup.
- A systematic drug withdrawal and reintroduction protocol was employed, followed by regimen modification using levofloxacin as an isoniazid substitute.
Main Results:
- The patient exhibited a clear temporal relationship between isoniazid ingestion and the onset of flu-like symptoms.
- All other components of the antitubercular therapy were well-tolerated.
- Substitution of isoniazid with levofloxacin led to complete resolution of symptoms and successful treatment of pulmonary tuberculosis.
Conclusions:
- Isoniazid is a potential, albeit rare, cause of flu-like syndrome in patients undergoing treatment for tuberculosis.
- Clinicians should maintain a high index of suspicion for isoniazid-induced flu-like syndrome, especially when symptoms correlate with drug intake.
- Regimen modification, including the use of alternative agents like levofloxacin, can effectively manage this adverse effect and ensure treatment completion.
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