Patch-testing For The Management Of Hypersensitivity Reactions To Second-line Anti-tuberculosis Drugs: A Case Report. - Info and Reading Options
By Khan, Samsuddin, Andries, Aristomo, Pherwani, Asha, Saranchuk, Peter and Isaakidis, Petros
"Patch-testing For The Management Of Hypersensitivity Reactions To Second-line Anti-tuberculosis Drugs: A Case Report." and the language of the book is English.
“Patch-testing For The Management Of Hypersensitivity Reactions To Second-line Anti-tuberculosis Drugs: A Case Report.” Metadata:
- Title: ➤ Patch-testing For The Management Of Hypersensitivity Reactions To Second-line Anti-tuberculosis Drugs: A Case Report.
- Authors: Khan, SamsuddinAndries, AristomoPherwani, AshaSaranchuk, PeterIsaakidis, Petros
- Language: English
Edition Identifiers:
- Internet Archive ID: pubmed-PMC4141085
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"Patch-testing For The Management Of Hypersensitivity Reactions To Second-line Anti-tuberculosis Drugs: A Case Report." Description:
The Internet Archive:
This article is from <a href="//archive.org/search.php?query=journaltitle%3A%28BMC%20Research%20Notes%29" rel="ugc nofollow">BMC Research Notes</a>, <a href="//archive.org/search.php?query=journaltitle%3A%28BMC%20Research%20Notes%29%20AND%20volume%3A%287%29" rel="ugc nofollow">volume 7</a>.<h2>Abstract</h2>Background: The second-line anti-tuberculosis drugs used in the treatment of multidrug-resistant tuberculosis often cause adverse events, especially in patients co-infected with the human immunodeficiency virus. Severe hypersensitivity reactions due to these drugs are rare and there is little published experience to guide their management. Case presentation: A 17-year old Indian female multidrug-resistant tuberculosis patient co-infected with human immunodeficiency virus developed a hypersensitivity reaction after starting second-line anti-tuberculosis treatment in Mumbai, India. The patient was being treated with kanamycin, moxifloxacin, para-aminosalicylic acid, cycloserine, clofazimine, and amoxicillin-clavulanic acid. Twenty-four hours later, the patient developed generalized urticaria, morbilliform rash and fever. All drugs were suspended and the patient was hospitalised for acute management. Skin patch-testing was used to identify drugs that potentially caused the hypersensitivity reaction; results showed a strong reaction to clofazimine, moderate reaction to kanamycin and mild reaction to cycloserine. An interim second-line anti-tuberculosis regimen was prescribed; cycloserine and kanamycin were then re-challenged one-by-one using incremental dosing, an approach that allowed clinicians to re-introduce these drugs promptly and safely. The patient is currently doing well. Conclusions: This is the first case-report of a multidrug-resistant tuberculosis patient co-infected with the human immunodeficiency virus with hypersensitivity reaction to multiple second-line anti-tuberculosis drugs. Skin patch-testing and controlled re-challenge can be a useful management strategy in such patients. There is an urgent need for second-line anti-tuberculosis regimens that are more effective, safe and better tolerated.
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