Meningitis or madness: a delicate balance.
A child with meningitis who developed a psychosis 2 weeks after commencing treatment with antituberculous therapy is described here. The psychosis resolved with cessation of isoniazid, but the meningitis returned. The meningitis was treated by re-introduction of daily doses of isoniazid, but the psychosis recurred. Successful treatment of the meningitis, with minimal psychotic symptoms, eventually was achieved using isoniazid at 48 h dose intervals. The psychosis resolved completely after completion of therapy for tuberculous meningitis and cessation of isoniazid. This is the first case of isoniazid-associated psychosis reported in a child.
Duke
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T
Department of Paediatrics, Goroka Base Hospital, Papua New Guinea. duke@global.net.pg
Mai
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M
D000995:Antitubercular Agents / Q000008:administration & dosage / Q000009:adverse effects*; D002648:Child; D006801:Humans; D007538:Isoniazid / Q000008:administration & dosage / Q000009:adverse effects*; D008297:Male; D011605:Psychoses, Substance-Induced; D014390:Tuberculosis, Meningeal / Q000188:drug therapy*
D000995:Antitubercular Agents; D007538:Isoniazid