Drug Induced Ototoxicity in Patient with Tuberculosis

Author: Rohit Bangwal*, Shipra Omar, Sahil Sharma, Prashant Mathur

Streptomycin is the most important aminoglycoside of antibiotic family, that usually employed TB and different advanced gram-negative microorganism infections. All aminoglycosides (AGs) have the potential to induce irreversible / reversible ototoxicity, neuromuscular blockage & nephrotoxicity. In this case study,37 years old man, weighing 53 kg was brought to the hospital with chief complains of tinnitus, hearing loss, fever (on/off), cough with expectoration and vertigo from last 5-6 days. He had a known case of relapsed smear positive pulmonary tuberculosis (PTB) and was taking regular IInd line anti-tubercular drugs therapy (Ionized, Rifampicin, Pyrazinamide, Ethambutol, and Streptomycin) in the last1 month. Pulmonologist had stopped the Streptomycin 0.75g BD injection, because this drug was responsible for ototoxicity in patient, but other IInd line ATT medication was continued. Pulmonologists had found the provisional & final diagnosis of anti-tubercular drug (Streptomycin) induced ototoxicity on the bases of subjective and objective observation. Although there are many case reports already done previously, AGs induced ototoxicity particularly in TB patients, we come over the Ist case of AGs induced ototoxicity in TB patients. In this case patient condition was resolved only after discontinuation of streptomycin.

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