Rifampicin and Pulmonary Fibrosis

To the Editor.  —Although antitubercular agents have been shown to produce adverse effects varying from unimportant to life-threatening,¹ pulmonary fibrosis due to these drugs is very rare. Davies² reported that pulmonary fibrosis was observed in a patient who developed a systemic lupus erythematosus—like syndrome due to treatment with isoniazid. However, there is little information on rifampicin-induced pulmonary fibrosis. I recently encountered a 79-year-old man in Japan with pulmonary fibrosis due probably to rifampicin therapy.

Report of a Case.  —The patient was admitted because of fever and a productive cough of four-months duration. Criteria for the diagnosis of pulmonary tuberculosis were clinical symptoms, positive sputum cultures of Mycobacterium tuberculosis, and chest roentgenograms revealing infiltrative shadows in the right middle lobe and in the anterior segment of the right upper lobe. Three months of chemotherapy with rifampicin (0.3 g/d, because his weight was 42 kg), isoniazid (0.4 g/d), and ethambutol