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首页> 外文期刊>Journal of Clinical and Diagnostic Research >Isoniazid Induced Toxic Epidermal Necrolysis in a HIV Positive Patient during Treatment for Extra Pulmonary Tuberculosis: A Case Report
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Isoniazid Induced Toxic Epidermal Necrolysis in a HIV Positive Patient during Treatment for Extra Pulmonary Tuberculosis: A Case Report

机译:异烟肼诱导的HIV阳性患者在治疗额外肺结核期间发生毒性表皮坏死:1例报告

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Toxic Epidermal Necrolysis (TEN) is characterised by extensive erythema, necrosis, and bullous detachment of the epidermis and mucous membranes. Drug induced TEN is commonly seen with sulphonamides, penicillins, other antibiotics, non-steroidal anti-inflammatory drugs, anticonvulsants etc., Human Immunodeficiency Virus (HIV) infected patients are more susceptible to these drug reactions than the general population.Isoniazid (INH) remains one of the first line agent for Antitubercular Therapy (ATT) in HIV patients co-infected with tuberculosis. An alteration in the treatment of tuberculosis is recommended if the patient develops TEN on any first line antitubercular drugs. Here, we report a case of INH induced TEN in a HIV patient during treatment for extra pulmonary tuberculosis. She was non-compliant to the Antiretroviral Therapy (ART) drugs and was on ATT drugs (INH and ethambutol) for the past four months. She was admitted to the hospital with the complaints of extensive skin lesions of one-week duration which was diagnosed to be TEN clinically and also based on the biopsy report. The frequency of INH causing TEN was not defined by the clinical trial investigators, however this was suspected to be due to INH. The severe cutaneous adverse reaction subsided after the withdrawal of INH followed by the supportive therapy for skin lesions.
机译:有毒的表皮坏死症(TEN)的特征是表皮和粘膜出现广泛的红斑,坏死和大疱性脱离。药物诱发的TEN通常与磺胺类药物,青霉素,其他抗生素,非甾体抗炎药,抗惊厥药等一起见到。感染人类免疫缺陷病毒(HIV)的患者比一般人群更容易受到这些药物反应的影响。仍然是合并感染结核病的HIV患者抗结核治疗(ATT)的首选药物之一。如果患者在任何一线抗结核药物上发展为TEN,则建议改变结核病的治疗方法。在这里,我们报道了一名HIV病人在治疗额外肺结核期间INH诱发TEN的病例。在过去四个月中,她不服从抗逆转录病毒疗法(ART)药物,并且一直服用ATT药物(INH和乙胺丁醇)。她因患有持续一周的广泛皮肤病变而入院医院,该病变在临床上也根据活检报告被诊断为TEN。临床试验的研究者并未确定引起TEN的INH的发生频率,但是怀疑是由于INH引起的。停用INH后严重的皮肤不良反应消退,随后对皮肤病变进行支持治疗。

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