Drug-Induced Fulminant Hepatitis in a Child Treated for Latent Multidrug-Resistant Tuberculosis With Dual Therapy Combining Pyrazinamide and Levofloxacin

Pediatr Infect Dis J. 2019 Oct;38(10):1025-1026. doi: 10.1097/INF.0000000000002413.

Abstract

We report the case of a 10-year-old child treated for latent tuberculosis infection (LTBI) with pyrazinamide (PZA) and levofloxacin after contact with a smear-positive multidrug-resistant tuberculosis adult. Over the course of the treatment, the patient developed a drug-induced fulminant hepatitis attributed to the combination of PZA and levofloxacin. This case highlights the hepatotoxicity of the association of second-line anti-TB treatment in children.

Publication types

  • Case Reports

MeSH terms

  • Antitubercular Agents / administration & dosage
  • Antitubercular Agents / adverse effects*
  • Child
  • Drug Therapy, Combination / adverse effects
  • Drug Therapy, Combination / methods
  • Humans
  • Latent Tuberculosis / complications*
  • Latent Tuberculosis / drug therapy*
  • Levofloxacin / administration & dosage
  • Levofloxacin / adverse effects
  • Male
  • Massive Hepatic Necrosis / chemically induced*
  • Massive Hepatic Necrosis / pathology*
  • Pyrazinamide / administration & dosage
  • Pyrazinamide / adverse effects
  • Tuberculosis, Multidrug-Resistant / complications*
  • Tuberculosis, Multidrug-Resistant / drug therapy*

Substances

  • Antitubercular Agents
  • Pyrazinamide
  • Levofloxacin