Abstract

AKT 4 INDUCED DELIRIUM: CASE REPORT

Shreya Jani*, Yatri Dave, Param Bhatt, Dr. Cyril Sajan

.

Abstract

Tuberculosis (TB) is the major problem in countries like India or developing countries. Anti- tubercular drugs prescribed for TB can cause certain side effects in patients, these can be dose related, due to genetics or resistance to anti TB drugs. Delirium or psychosis caused by AKT-4 is reported in many patients taking AKT- 4 therapy for TB. Especially Isoniazide and Ethambutol can cause psychosis. A 21 years old male patient came with the complaints of high- grade fever with chills and altered sensorium since 3- 4 days. He had 1 episode of vomiting. He had seizure attack 3 days back (3 episodes for 1-2 mins) associated with involuntary movements of bilateral upper limb and lower limb with up rolling of eyes, post ictal confusion. Patients had TB 6 months back for which he had taken AKT-4 and he completed his regimen 1 month back. His X- Ray and CBNAAT (Cartridge- based nucleic acid amplification test) confirming of TB. MRI (Magnetic Resonance Imaging) brain suggests flair and hyperintense lesion with low ADC is seen in left superior temporal cortex that appeared a tiny acute infarct. Patient took discharge against medical advice, so treatment is discontinued. Proper identification of delirium causing drug in anti TB therapy can prevent delirium in patient by discontinuing the particular drug or by changing the dose.

Keywords: tuberculosis, meningitis, Anti TB therapy, delirium, Isoniazide, ethambutol.