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Case Reports
. 2019;58(2):263-266.
doi: 10.2169/internalmedicine.1369-18. Epub 2018 Jan 15.

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

Nobuhiro Fujishima  1   2 , Kosaku Komiya  1 , Naoko Matsunaga  2 , Yuko Usagawa  1 , Mari Yamasue  1 , Kazuhiko Hashinaga  1 , Kenji Umeki  1 , Shin-Ichi Nureki  1 , Masaru Ando  1 , Terufumi Matsunaga  2 , Jun-Ichi Kadota  1
Affiliations
Case Reports

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

Nobuhiro Fujishima et al. Intern Med. 2019.

Abstract

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.

Keywords: elderly; pneumonia; tosufloxacin; tuberculosis.

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Conflict of interest statement

The authors state that they have no Conflict of Interest (COI).

Figures

Figure 1.
Figure 1.
Chest X-ray findings at the first visit (A), seven days after the start of the tosufloxacin administration (B), three weeks after the end of the administration of tosufloxacin (C) and two months after the start of treatment with multi-antituberculous drugs (D).
Figure 2.
Figure 2.
Chest CT findings at three weeks after the end of the administration of tosufloxacin at the same time as in Fig. 1 (C).
See this image and copyright information in PMC

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