Acute isoniazid poisoning simulating meningoencephalitis

Ehsan, Tajammul; Malkoff, Marc

doi:10.1212/wnl.45.8.1627

Cited by 4 publications

(2 citation statements)

References 2 publications

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“…The relationship of CSF pleocytosis with seizures related to isoniazid intoxication in two of the reports (involving five patients) 4 , 5 is interesting. This has been subsequently reported in an additional case report 34 . Isoniazid intoxication may induce a CSF pleocytosis through a mechanism that has not yet been defined.…”

Section: Discussionmentioning

confidence: 79%

“…This has been subsequently reported in an additional case report. 34 Isoniazid intoxication may induce a CSF pleocytosis through a mechanism that has not yet been defined. Observations from these studies gave rise to the widely held and accepted concept that in a minority of cases seizures themselves are the probable cause of CSF pleocytosis through unknown mechanisms.…”

Section: Discussionmentioning

confidence: 99%

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Cerebrospinal Fluid Pleocytosis in Critical Care Patients With Seizures

Scramstad

Jackson

2017

Can. J. Neurol. Sci.

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We conclude that seizures do not directly induce a CSF pleocytosis. Instead, the CSF pleocytosis more likely reflects the underlying acute or chronic brain process responsible for the seizure(s). This was not readily apparent in early studies without magnetic resonance imaging (MRI) of the brain and currently available laboratory investigations. An etiological cause of CSF pleocytosis must always be sought when patients present with seizures and it should never be assumed that seizures are the cause.

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Section: Discussionmentioning

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Cerebrospinal Fluid Pleocytosis in Critical Care Patients With Seizures

Scramstad

Jackson

2017

Can. J. Neurol. Sci.

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Drug-induced aseptic meningitis

Hopkins

Jolles

2005

Expert Opinion on Drug Safety

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Isoniazid Overdose

Maw

Aitken²

2003

Clinical Drug Investigation

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Tuberculosis has re-emerged as a significant public health threat over the last decade both globally and within Australia. This is thought to be largely due to the HIV epidemic, a growing itinerant population, and immigration. The antibiotic isoniazid remains an integral part of drug therapy. With the numbers of patients receiving isoniazid remaining high, the number of cases of acute poisoning is expected to be significant. This paper presents a series of two cases of isoniazid poisoning presenting to a tertiary referral centre in North Queensland. Isoniazid toxicity produces a triad of coma, metabolic acidosis and seizures. The seizures are often refractory to traditional antiepileptics. A specific antidote is available (pyridoxine [vitamin B6]) and both patients were administered this as part of their treatment. We also surveyed all hospitals in Australia with an accredited adult Emergency Department to assess the availability of pyridoxine.

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Acute isoniazid poisoning simulating meningoencephalitis

Cited by 4 publications

References 2 publications

Cerebrospinal Fluid Pleocytosis in Critical Care Patients With Seizures

Cerebrospinal Fluid Pleocytosis in Critical Care Patients With Seizures

Drug-induced aseptic meningitis

Isoniazid Overdose

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