ArticleMedicine2025
Fulminant hepatitis during treatment for per-extensively drug-resistant tuberculosis: A case report and call for improved patient monitoring.
Article in Medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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9 authors.
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Abstract
rationaleDrug therapy is the most effective therapy for tuberculosis; however, it can also lead to a common and serious adverse reaction known as antituberculosis drug-induced liver injury. The incidence of antituberculosis drug-induced liver injury ranges from 2.0% to 28.0%. PATIENT CONCERNS: Here, we report the successful treatment of drug-induced fulminant hepatitis in a 19-year-old patient with extensively drug-resistant tuberculosis. DIAGNOSES: The patient was treated with a combination of bedaquiline, linezolid, cycloserine, clofazimine, amikacin, ethambutol, and pyrazinamide. This combination was selected because the patient showed resistance to rifampicin, isoniazid, and fluoroquinolones in a drug resistance test. However, for personal reasons, the patient did not follow the doctor's advice and developed fulminant hepatitis induced by antituberculosis drugs.
interventionsAntituberculosis drugs were immediately discontinued, and the patient received clinical treatment for liver protection, jaundice elimination, artificial liver support, and infusion of fibrinogen and prothrombin complex. OUTCOMES: Gradually, the patient's liver function returned to normal. LESSONS: This case report highlights the importance of regular liver function monitoring during antituberculosis therapy to ensure patient safety.
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