Frostbite secondary to antimycobacterial-induced peripheral neuropathy: a case report

Area of Science:

• Neurology
• Infectious Diseases
• Dermatology

Background:

• Antimycobacterial drugs, like isoniazid (INH), are essential for treating tuberculosis (TB).
• Drug-induced peripheral neuropathy (DIPN) is a known side effect of some TB medications.
• Peripheral neuropathy (PN) can manifest with sensory and motor deficits, potentially impacting temperature sensation.

Observation:

• A unique case report details severe bilateral foot frostbite in a patient with antimycobacterial-induced peripheral neuropathy (PN).
• The patient experienced neuropathic pain, leading to the use of harmful practices like ice immersion for relief.
• This resulted in significant tissue damage due to impaired temperature sensation and vasoconstriction.

Findings:

• Antimycobacterial-induced PN can present with unusual and severe complications, such as frostbite.
• Impaired sensation in PN can lead to patients unknowingly exposing extremities to extreme cold.
• The mechanism may involve drug toxicity affecting nerve function and subsequent vascular responses.

Implications:

• Highlights the critical need for early identification and management of PN in patients on antimycobacterial therapy.
• Emphasizes patient education on medication side effects and risks associated with self-treatment for neuropathic pain.
• Advocates for a multidisciplinary approach to prevent severe complications like frostbite and improve patient outcomes.