Reaction to cheese during TB treatment

We describe a case of a reaction to cheese in a patient with tuberculosis (TB) while on treatment with isoniazid. A 26 year old woman diagnosed with breast TB after isolation of drug sensitive Mycobacterium tuberculosis by breast nodule biopsy was started on treatment on 18 February 2003 with four drugs (rifampin 600 mg/day, isoniazid 300 mg/day, pyrazinamide 2 g/day, and ethambutol 1.2 g/day). On 14 April she came for the scheduled medical visit reporting episodes of facial flushing, respiratory distress (“constriction of throat”), and headache. The first episode was noticed on 30 March while dining and lasted 30 minutes. The same symptoms occurred the following day during lunch; the blood pressure measured during the episode was 110/90 (normally 85/60). A further two similar episodes occurred, one of which was not associated with eating. The patient denied digestive symptoms, a history of atopia, or the use of …