Katsube Otohiro, Anzai Makiko, Nomura Yushi, Ikeda Naoya, Takizawa Hidenori, Kikkawa Yasuko, Numao Toshio
Kekkaku. 2014 Feb;89(2):51-6.
The patient was a 27-year-old man with pulmonary tuberculosis, who was initially treated with isoniazid, rifampicin, ethambutol, and pyrazinamide. However, because of hepatic dysfunction and visual impairment, the four-drug therapy was switched to a three-drug regimen with isoniazid, rifampicin, and levofloxacin. At 9 weeks after the initiation of levofloxacin, the patient developed cervical lymphadenopathy, fever, systemic erythema, and hepatic dysfunction. He was diagnosed with drug-induced hypersensitivity syndrome (DIHS) based on positive results in the human herpesvirus (HHV)-6 DNA test, an indicator of HHV-6 reactivation. The symptoms improved after withdrawal of the antituberculosis drugs and initiation of steroid administration. However, considering the risk of relapse of DIHS, the tuberculosis treatment, which was initially planned for 9 months, was stopped at 7 months. Neither DIHS nor tuberculosis recurred.
该患者为一名27岁的肺结核男性，最初接受异烟肼、利福平、乙胺丁醇和吡嗪酰胺治疗。然而，由于肝功能障碍和视力损害，四联疗法改为异烟肼、利福平及左氧氟沙星的三联疗法。左氧氟沙星治疗9周后，患者出现颈部淋巴结病、发热、全身性红斑及肝功能障碍。基于人类疱疹病毒（HHV）-6 DNA检测结果呈阳性（HHV-6再激活的指标），他被诊断为药物性超敏反应综合征（DIHS）。停用抗结核药物并开始给予类固醇治疗后，症状有所改善。然而，考虑到DIHS复发的风险，最初计划为期9个月的抗结核治疗在7个月时停止。DIHS和结核病均未复发。
