Réaction allergique aux antituberculeux majeurs

Allergic reactions to antituberculosis drugs are rare. Sometimes they are fatal, so they must be diagnosed for an efficacy treatment of the active tuberculosis. In this case, allergic reactions occurred on the third day of antituberculosis treatment. He has a rash on his legs. Antibiotics were reintroduced separately in hospital, without problem for isoniazide and ethambutol. Apparently there is no problem with rifampicin, but pyrazinamide reintroduction gives a bronchospasm. After giving the three others drugs, he has an anaphylactic reaction. This patient has no biologic disorder. Clinical signs and skin tests permitted the diagnosis of allergy both to rifampicin and pyrazinamide. Induction of immune tolerance makes possible tuberculosis treatment with the three major drugs. Rapidly he develops an ophthalmic complication needed replacement of ethambutol by fluoroquinolone. Recognizing allergic reaction is sometimes difficult, biologic is not always positive and its realization sometimes difficult in general hospital. We can have several allergic drugs.