Meningitis or madness: A delicate balance

A child with meningitis who developed a psychosis 2 weeks after commencing treatment with antituberculous therapy is described here. The psychosis res olved with cessation of isoniazid, but the meningitis returned. The meningi tis was treated by re-introduction of daily doses of isoniazid, but the psy chosis recurred. Successful treatment of the meningitis, with minimal psych otic symptoms, eventually was achieved using isoniazid at 48 h dose interva ls. The psychosis resolved completely after completion of therapy for tuber culous meningitis and cessation of isoniazid. This is the first case of iso niazid-associated psychosis reported in a child.