{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T07:58:03Z","timestamp":1785398283352,"version":"3.56.0"},"reference-count":26,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:00:00Z","timestamp":1785283200000},"content-version":"vor","delay-in-days":209,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Case Reports in Infectious Diseases"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Antituberculous drugs carry substantial hepatotoxic risk, most commonly manifesting as idiosyncratic drug\u2013induced liver injury. Although cases of antituberculosis drug\u2013induced liver injury (AT\u2010DILI) have been reported in Ghana, significant challenges remain in its diagnosis, monitoring, and management in low\u2010resource settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Symptoms and Clinical Findings<\/jats:title>\n                    <jats:p>We report the case of a 50\u2010year\u2010old woman who developed severe AT\u2010DILI, initially misdiagnosed as cholecystitis, on a background of chronic hepatitis C infection with established liver cirrhosis. She was referred to the Tamale Teaching Hospital during the continuation phase of first\u2010line antituberculosis therapy, presenting with nausea, anorexia, and right upper quadrant abdominal pain. A clinical examination revealed mild pallor, jaundice, Grade 1 bilateral pitting pedal edema, and moderate ascites.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Diagnosis, Therapeutic Intervention, and Outcome<\/jats:title>\n                    <jats:p>At the referral facility, diagnostic and monitoring constraints were encountered, including the unavailability of liver biopsy, the lack of routine baseline liver function testing, and out\u2010of\u2010pocket costs for serial laboratory monitoring. In addition, the absence of single\u2010drug formulations of isoniazid and rifampicin precluded sequential rechallenges, necessitating rechallenges with a fixed\u2010dose combination during the continuation phase. The patient failed rechallenge and was transitioned to an all\u2010oral second\u2010line antituberculous regimen consisting of bedaquiline, pretomanid, linezolid, and moxifloxacin, alongside direct\u2010acting antiviral therapy for chronic hepatitis C. This resulted in the resolution of liver injury and the successful completion of tuberculosis treatment without complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case highlights the diagnostic and management challenges of AT\u2010DILI in low\u2010resource settings, particularly where baseline liver function testing, serial monitoring, and access to single\u2010drug formulations for rechallenge are limited.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/crdi\/1056322","type":"journal-article","created":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T07:00:12Z","timestamp":1785394812000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Diagnosis, Management, and Outcome of Antituberculous Drug\u2013Induced Liver Injury in a Low\u2010Resource Setting: A Case Report"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1587-7038","authenticated-orcid":false,"given":"Samuel","family":"Alomatu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4749-4258","authenticated-orcid":false,"given":"Mirabel Kah-Keh","family":"Nanjoh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salimatu Asam","family":"Moro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John Gerald A.","family":"Adiiboka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pascal Deeshini Aliu","family":"Alhassan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-5421-8411","authenticated-orcid":false,"given":"Odalys Rivera","family":"Hernandez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,29]]},"reference":[{"key":"e_1_2_13_1_2","doi-asserted-by":"publisher","DOI":"10.1155\/2022\/8266878"},{"key":"e_1_2_13_2_2","doi-asserted-by":"crossref","DOI":"10.1016\/j.ijregi.2025.100665","article-title":"Anti-Tuberculosis Drug\u2013Induced Hepatotoxicity and Associated Risk Factors Among Patients With Pulmonary Tuberculosis at a Tertiary Care Hospital in Thailand","volume":"15","author":"Mukura S.","year":"2025","journal-title":"IJID Regions"},{"key":"e_1_2_13_3_2","unstructured":"BotchwayE. 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