Abstract

Isoniazid (INH) toxicity is a rare clinical condition with a high mortality rate. A 12-year-old girl admitted to our emergency department with generalized convulsive status epilepticus is presented. Physical examination revealed a heart rate of 114 beats per minute, blood pressure 125/85 mmHg, a temperature of 37.2°C. After establishing a secure airway, an intravenous access was obtained and diazepam (0.15 mg/kg IV) and phenytoin (15 mg/kg IV) were given immediately. She was then taken into pediatric intensive care unit because her seizures did not subside despite diazepam and phenytoin administration. The seizures were controlled after initiation of midazolam infusion (0.2 mg/kg IV bolus, followed by an infusion of 0.1 m g/kg/h). She had no history of any previous illness but we have learned from her family history that an elder s is ter was taking therapy for pulmonary tuberculosis. At the fourth hour of her admission, her family notified that fifteen of INH tablets (4.5 g) had been lost. Thereafter, the patient was treated with multiple doses of activated charcoal and 4.5 g of pyridoxine with the diagnosis of acute INH poisoning. She was discharged after 5 days without any sequaele. The case is presented in order to emphasize that 'ısoniazid poisoning should be kep t in mind in any child presenting with unexplained status epilepticus, since tuberculosis is stili a public health problem in our country.