Report of a Case of Miliary Tuberculosis and Tuberculous Meningitis Treated with Isoniazid

¹ Lake View Sanatorium.

Since the initial 30-day period of treatment with streptomycin and para-aminosalicylic acid was not adequate to account for the improvement and subsequent recovery of this patient, it may be assumed that isoniazid, which was used alone thereafter, was the effective agent responsible for these developments. Ritchie, Taylor, and Dick⁷ have described the significant histological findings that lesions of miliary and meningeal tuberculosis undergo resolution with isoniazid while similar lesions treated with streptomycin fibrose. When these two drugs are used in combination the isoniazid effect predominates. The mortality rate and the incidence of neurological sequelae (from either meningitis or from treatment with intrathecal streptomycin) is still high with currently accepted antibiotic regimens. Until more is known about isoniazid in the treatment of miliary and meningeal tuberculosis the combination of isoniazid, streptomycin (intramuscular) and possibly para-aminosalicylic acid may be the regimen of choice. The present case has demonstrated marked therapeutic effect from isoniazid alone.[See Table in source PDF]