Drug-Induced Maculopapular Rash Following Initiation of Anti-Tubercular Therapy: A Case Study

Background: Cutaneous adverse drug reactions (CADRs) are recognized complications of first-line anti-tubercular therapy (ATT), with maculopapular eruptions being the most common. These reactions typically occur within the first two weeks of therapy and may affect adherence if not promptly identified. Introduction: Although usually mild, maculopapular rashes can lead to treatment interruption and unnecessary modification of therapy. Early detection and careful management are essential to maintain effective TB treatment. Case Presentation: A 60-year-old female with microbiologically confirmed pulmonary tuberculosis developed a generalized erythematous maculopapular rash 13 days after starting fixed-dose combination therapy (rifampicin, isoniazid, pyrazinamide, and ethambutol). Laboratory parameters were normal except for mild hypoalbuminemia, likely due to chronic illness. The reaction was managed symptomatically with oral antihistamines while continuing ATT, and the rash resolved completely without recurrence. Conclusion: This case highlights the importance of vigilant monitoring and early recognition of cutaneous ADRs during ATT to ensure adherence and prevent unnecessary drug discontinuation.