A 65-year-old man comes to the hospital due to progressive fatigue and fever. He emigrated from Sri Lanka 2 years ago. His most recent examination 2 months ago included purified protein derivative (PPD) skin testing and showed an induration of 12 mm. He started isoniazid therapy with pyridoxine supplementation. On physical examination, there is mild abdominal discomfort. Laboratory studies are pending. Which of the following is the most likely cause of this patient's current symptoms?

Question

A 65-year-old man comes to the hospital due to progressive fatigue and fever. He emigrated from Sri Lanka 2 years ago. His most recent examination 2 months ago included purified protein derivative (PPD) skin testing and showed an induration of 12 mm. He started isoniazid therapy with pyridoxine supplementation.  On physical examination, there is mild abdominal discomfort.  Laboratory studies are pending.  Which of the following is the most likely cause of this patient's current symptoms?

Quizplus · Accepted Answer

Eductional Objective: Isoniazid can be directly hepatotoxic, causing acute, mild hepatic dysfunction in 10%-20% of patients and frank hepatitis (fever, anorexia, and nausea, sometimes progressing to hepatic failure) in a small percentage of patients.

A 65-Year-Old Man Comes to the Hospital Due to Progressive