Title: Multi Drug Hypersensitivity Syndrome (MDHS) in a Case of Tubercular Meningitis- A Case Report
Authors: Anirban Saha, Rekha Manjhi, Aurobindo Behera
DOI: https://dx.doi.org/10.18535/jmscr/v11i2.06
Abstract
Multi drug hypersensitivity syndrome (MDHS) is often challenging as it endangers patient compliance as well as treatment failure. It develops due to dysregulated cell mediated immunity that results in drug hypersensitivity reactions (DHR) and is characterized by severe exanthems or drug rash with eosinophilia &systemic symptoms (DRESS).
DHR is very common among patients on anti-tubercular therapy (ATT) for Pulmonary as well as Extra-Pulmonary Tuberculosis (EPTB), particularly with 1st line anti tubercular drugs like ethambutol, pyrazinamide, Rifampicin & Isoniazid. But reporting of MDHS has been low in India, despite having high burden of tuberculosis.
A 13-year-old female child, on ATT for Tubercular Meningitis (TBM), presented to us with DHR, was found out to have MDHS and was managed tactfully with an alternate regimen.
TB meningitis is a severeform of EPTB that needs aggressive treatment to avoid neurological complications & sequelae.
For these patients, it was crucial to identify the offending drug as soon as possible and restart a suitable alternate regimen in order to reduce morbidity and mortality.
Keywords: MDHS, EPTB, TB-Meningitis, ATT.
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