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Coma From Long-term Overingestion of Isoniazid

Alan R. Salkind, MD; Carla C. Hewitt, MD
Arch Intern Med. 1997;157(21):2518-2520. doi:10.1001/archinte.1997.00440420156017.
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Overingestion of isoniazid can cause confusion, slurred speech, seizures, coma, and death. Most cases of a central nervous system toxic reaction due to isoniazid use result from sudden intentional or accidental overdose. We describe a patient taking 1200 mg of isoniazid daily for 6 weeks who presented to the hospital with confusion and lethargy that progressed to coma. Within 30 minutes of receiving 1 g of intravenous pyridoxine hydrochloride, the patient was fully alert and lucid. The diagnosis of a toxic reaction to isoniazid was delayed by the possibility of concurrent active neurosyphilis and the failure to initially consider isoniazid poisoning in a patient without a history of sudden isoniazid overdose.

Arch Intern Med. 1997;157:2518-2520


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