The outcome of linezolid induced optic and peripheral neuropathy in a Pakistani patient treated for multidrug-resistant pulmonary tuberculosis: A case report

Abstract Linezolid is a core second-line drug used for the treatment of extensively and multidrug-resistant tuberculosis. Linezolid showed the promised efficacy in the treatment of drugs resistant tuberculosis. However, the associated adverse effects such as optic and peripheral neuropathy are the major obstacles for its long-term therapy. We recently encountered a case of progressive deterioration of vision and numbness in the feet in a 32-years-old male undergoing linezolid therapy for 12 months for multidrug-resistant tuberculosis. Nerve conduction studies were highly suggestive of length dependent axonal sensory polyneuropathy while the fundoscopic image was highly favorable of optic neuropathy. A slight improvement was seen in vision with no improvement or worsening of peripheral neuropathy on follow-up visits after the discontinuation of linezolid. In a developing country like Pakistan, whereas the management of developing resistance to tuberculosis is a major problem, awareness among physicians for close follow-up of a patient using long-term linezolid therapy should be created to avoid such serious optic and peripheral neuropathy.