• D Ang, A A L Hsu, and B H Tan.
• Department of Internal Medicine, Singapore General Hospital, Outram Road, Singapore 169608.
• Singap Med J. 2006 Sep 1;47(9):747-51.

IntroductionFluoroquinolones (FQs), frequently used for many common infections such as community-acquired pneumonia and urinary tract infection, are also effective against Mycobacterium tuberculosis. This study describes a series of patients in whom the empirical use of FQs for what appeared to be common community-acquired infections led to a delay in the diagnosis of tuberculosis (TB).MethodsWe reviewed the records of five patients with TB in whom the early use of FQs led to partial symptom resolution and a prolonged relapsing and remitting course.ResultsOf the five patients described, four presented with community-acquired pneumonia and one with urinary tract infection. All were given FQs and improved, though not completely. Their illnesses took a relapsing and remitting course. TB was eventually diagnosed, in four of them by culture and in one by characteristic histopathology (this patient required surgical resection of a lung abscess).ConclusionFQs may lead to partial symptom resolution in TB. We highlight the problem of a delayed diagnosis, and voice our concern about inadvertent monotherapy of TB in such cases.

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