title: Pulmonary tuberculoma in a patient with chronic hepatitis C: a clinical pitfall in the treatment strategy.
abstract: We herein report a clinical pitfall regarding the treatment of a case of pulmonary tuberculoma in a patient with chronic hepatitis C. The patient presented with both chronic hepatitis C and pulmonary tuberculoma, and we initiated treatment of the chronic hepatitis C first due to the potential for liver injury; however, the patient's condition worsened in terms of the pulmonary tuberculosis. This case highlights the need to select the initial treatment for pulmonary tuberculoma, not chronic hepatitis C. In addition, we report that, although the administration of anti-tuberculosis chemotherapy regimens containing pyrazinamide (PZA) substantially increases the incidence of drug-induced hepatitis in patients with chronic hepatitis, we were fortunately able to use PZA without observing drug-induced hepatitis in this case because we closely monitored the patient's liver function.
authors.affiliation: Department of Internal Medicine, Matsusakakousei Hospital, Japan.
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Saitou
authors.forename: Osamu
authors.initials: O
authors.lastname: Hatazi
authors.forename: Hiromi
authors.initials: H
authors.lastname: Aonuma
authors.forename: Suguru
authors.initials: S
authors.lastname: Ogura
authors.forename: Norihiko
authors.initials: N
authors.lastname: Yamamoto
authors.forename: Tetsu
authors.initials: T
authors.lastname: Kobayashi
mesh_terms: D000995:Antitubercular Agents / Q000627:therapeutic use*; D000998:Antiviral Agents / Q000627:therapeutic use*; D004279:DNA, Viral / Q000032:analysis; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D016174:Hepacivirus / Q000235:genetics; D019698:Hepatitis C, Chronic / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D061705:Image-Guided Biopsy; D007538:Isoniazid / Q000627:therapeutic use; D008168:Lung / Q000000981:diagnostic imaging / Q000382:microbiology / Q000473:pathology; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D017410:Practice Guidelines as Topic; D011718:Pyrazinamide / Q000627:therapeutic use; D012293:Rifampin / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed; D014375:Tuberculoma / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D014397:Tuberculosis, Pulmonary / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*
chemical_list: D000995:Antitubercular Agents; D000998:Antiviral Agents; D004279:DNA, Viral; D011718:Pyrazinamide; D007538:Isoniazid; D012293:Rifampin