Acute psychosis secondary to isoniazid in pediatric pulmonary tuberculosis

Isoniazid (INH) is a first-line tuberculosis (TB) drug and is currently recommended as part of active and latent TB treatment in all ages. INH adverse reactions range from mild hepatitis to severe neurological symptoms and psychosis. Since its introduction in the 1950s, many case reports have explored INH-induced psychosis. We describe a 12-year-old girl with acute onset hallucinations and delusions as a rare complication of INH and review previous case reports and identified risk factors. Pediatricians need to be aware of this less common side effect as they work through a differential of acute psychosis in children.