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Letters |15 February 1996

Tuberculosis: Yesterday, Today, and Tomorrow

Deborah K. Riley, MD; Timothy J. Babinchak, MD; Edward B. Rotherams Jr., MD

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  • Allegheny General Hospital; Pittsburgh, PA 15212
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TO THE EDITOR:
In his editorial on tuberculosis, Sbarbaro [1] states that directly administered therapy has become the standard of care in the treatment of tuberculosis. He goes on to say that “Physicians deviating from this standard put their patients and society at risk.” We report the case of a 61-year-old male farmer who was diagnosed with cavitary tuberculosis in November 1994. He received isoniazid, rifampin, and ethambutol daily for 2 months, followed by isoniazid (900 mg) and rifampin (600 mg twice weekly) under the direct observation of public health authorities. Two months into his intermittent therapy, he began to develop flu-like symptoms during the hours following the ingestion of his medications. The severity of these reactions increased after each dose. He suspected that his drugs were the cause but was persuaded to continue taking them. Ultimately, he presented to our hospital with fever, acute renal failure, hemolysis, thrombocytopenia, ataxia, and paresthesias. Eight days after his last dose of rifampin, these abnormalities resolved.
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Riley DK, Babinchak TJ, Rotherams EB. Tuberculosis: Yesterday, Today, and Tomorrow. Ann Intern Med. ;124:455. doi: 10.7326/0003-4819-124-4-199602150-00016

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Published: Ann Intern Med. 1996;124(4):455.

DOI: 10.7326/0003-4819-124-4-199602150-00016

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Print ISSN: 0003-4819 | Online ISSN: 1539-3704

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