PMC4901172_01
Chest radiographs. Before treatment with antituberculous drugs, chest radiograph showed an abnormal shadow in the left upper lung field (A). On admission, diffuse micronodular shadows in both lung fields appeared on the chest radiograph (B).
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The case was a 57-year-old man who presented with abnormal shadows in the left upper lung field on a chest radiograph that was taken during a routine health examination (Fig. 1-A). At this time, a chest radiograph showed diffuse micronodular shadows in both lung fields (Fig. 1-B) and on high-resolution CT (HRCT) of the chest there were diffuse numerous parenchymal micronodules in both lungs such as in hypersensitivity pneumonia (Fig. 2).
Chest radiographs on admission (A), one week after discontinuing the antituberculous drugs (B), and after reintroducing rifampicin, ethambutol, and isoniazid to which the patient was desensitized (C). One week after discontinuing the antituberculous drugs, diffuse micronodular shadows on chest radiograph rapidly improved without any medication (B). After reintroducing rifampicin, ethambutol, and isoniazid, there was no recurrence of abnormal shadows on the chest radiograph. (C).
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We suspected drug-induced pneumonia and stopped the antituberculous drugs, after which his symptoms and diffuse micronodular shadows on chest radiograph and HRCT (Fig. 3, Fig. 4B) rapidly improved without any medication, including corticosteroid. Desensitization to INH was successful, and RFP, EB, and INH were given for 9 months without any adverse events, including recurrence of the abnormal shadows on the chest radiographs and HRCT (Fig. 3, Fig. 4C).