A Pitfall of Treatment with Tosufloxacin for Pneumonia That Might Be Lung Tuberculosis

Tosufloxacin, which is not used to treat Mycobacterium tuberculosis, is a fluoroquinolone recommended for pneumonia when the possibility of tuberculosis infection cannot be excluded. In the present case, symptoms and chest infiltrative shadow initially improved by tosufloxacin. Therefore, we regarde...

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Bibliographic Details
Published in:Internal Medicine 2019/01/15, Vol.58(2), pp.263-266
Main Authors: Fujishima, Nobuhiro, Komiya, Kosaku, Matsunaga, Naoko, Usagawa, Yuko, Yamasue, Mari, Hashinaga, Kazuhiko, Umeki, Kenji, Nureki, Shin-ichi, Ando, Masaru, Matsunaga, Terufumi, Kadota, Jun-ichi
Format: Article
Language:English
Subjects:
Aged, 80 and over
Antibiotics
Case Report
Chest
Diagnosis, Differential
elderly
Fluoroquinolones - administration & dosage
Fluoroquinolones - adverse effects
Fluoroquinolones - therapeutic use
Humans
Internal medicine
Lungs
Male
Mycobacterium tuberculosis - isolation & purification
Naphthyridines - administration & dosage
Naphthyridines - adverse effects
Naphthyridines - therapeutic use
Pneumonia
Pneumonia, Bacterial - complications
Pneumonia, Bacterial - diagnosis
Pneumonia, Bacterial - diagnostic imaging
Pneumonia, Bacterial - drug therapy
Sputum
Sputum - microbiology
Tomography, X-Ray Computed
Tosufloxacin
Tuberculosis
Tuberculosis, Pulmonary - complications
Tuberculosis, Pulmonary - diagnosis
Tuberculosis, Pulmonary - diagnostic imaging
Tuberculosis, Pulmonary - drug therapy
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Summary:Tosufloxacin, which is not used to treat Mycobacterium tuberculosis, is a fluoroquinolone recommended for pneumonia when the possibility of tuberculosis infection cannot be excluded. In the present case, symptoms and chest infiltrative shadow initially improved by tosufloxacin. Therefore, we regarded this patient as having general pneumonia and did not perform follow-up chest X-ray until the infiltrates had completely disappeared. However, a few weeks later, the symptoms and the infiltrates had worsened, so M. tuberculosis was isolated from the patient's sputum. This case suggests that patients suspected of having pulmonary tuberculosis should be monitored carefully, even if antibiotics without antituberculous activity are initially effective.
ISSN:0918-2918
1349-7235
DOI:10.2169/internalmedicine.1369-18