Ethambutol Induced Optic Neuritis in a Patient of Tuberculous

Rajashish Chakrabortty1, Shamim Ahmed1, Malay Kumar Sur Chowdhury2,Sudipta Gope3, Goutom Kumar Acherjya4, Md. Khairul Hassan Jessy5

Abstract:
Tuberculous pleural effusion is one of the most common forms of
extrapulmonary tuberculosis (TB). The immediate cause of the effusion is a
delayed hypersensitivity response to mycobacterial antigens in the pleural
space. A reasonable management strategy for pleural TB would be to initiate
a four-drug regimen and perform therapeutic thoracentesis in patients with
large, symptomatic effusions. Ethambutol acts only on proliferating cells,
apparently by interfering with the synthesis of RNA by inhibiting the
incorporation of mycolic acid into the mycobacterial cell wall. Optic neuritis
has been described among the toxic effects of ethambutol. This side effect is
dose related and it may also occur as idiosyncratic reaction. The mean
duration of ethambutol induced optic neuritis (EON) is three months. We
report a case of ethambutol induced toxic neuritis after few days of exposure
to ethambutol and the symptoms resolved after discontinuation of ethambutol.
This most likely represents an idiosyncratic reaction which is different as
compared to dose related optic neuritis.
Key words: Tuberculosis (TB), Ethambutol induced optic neuritis (EON),
Adenosine deaminase (ADA), HIV (Human Immunodeficiency Virus), ATT
(Anti-Tubercular Therapy).

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