A 42-year-old man with active pulmonary tuberculosis is on antimicrobial therapy. After 6 weeks of treatment, he develops progressive numbness and tingling in his feet bilaterally. Vital signs are stable (BP 128/82, HR 78, RR 16, Temp 37°C). Physical examination reveals diminished ankle reflexes; chest X-ray shows improvement in infiltrates. Serum pyridoxine level is low at 8 ng/mL. He denies alcohol use. His physician adds pyridoxine supplementation. Which tuberculosis drug most likely caused this peripheral neuropathy?
- A)Rifampin
- B)IsoniazidGABARITO
- C)Streptomycin
- D)Pyrazinamide
- E)Ethambutol
Explicação
Isoniazid inhibits synthesis of mycolic acids in the mycobacterial cell wall and can cause peripheral neuropathy through pyridoxine deficiency. Vitamin B6 supplementation helps prevent this toxicity, especially in malnourished or predisposed patients. The neur... Ver explicação completa e trilha adaptativa →