A 55 year old patient with disseminated tuberculosis is prescribed drugs. Which of the following might be seen in patient of TB, who has regularly been injecting intramuscular injection of streptomycin:
**Core Concept**
Disseminated tuberculosis is a severe form of TB that has spread to multiple parts of the body, requiring aggressive treatment with multiple antibiotics. The use of aminoglycoside antibiotics like streptomycin in this context can lead to a specific side effect due to its mechanism of action.
**Why the Correct Answer is Right**
Streptomycin is an aminoglycoside antibiotic that acts by inhibiting protein synthesis in bacteria. It binds to the 30S ribosomal subunit, preventing the formation of the initiation complex and thus inhibiting the initiation of protein synthesis. However, aminoglycosides can also cause ototoxicity, particularly in patients with pre-existing hearing loss or renal impairment. The patient's history of injecting intramuscular streptomycin regularly may lead to permanent vestibular damage, characterized by a condition known as **Vestibular Neuropathy** or **Vestibular Toxicity**.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is not directly related to the use of streptomycin in TB treatment. Otosclerosis is a condition affecting the middle ear, unrelated to the mechanism of aminoglycosides.
**Option B:** This option is a side effect of other medications, such as Loop Diuretics, not aminoglycosides like streptomycin.
**Option C:** This option is not a direct consequence of streptomycin use in TB treatment. While aminoglycosides can cause nephrotoxicity, this is not the most likely answer choice given the context.
**Clinical Pearl / High-Yield Fact**
Aminoglycosides like streptomycin are ototoxic and can cause permanent vestibular damage, particularly with prolonged or high-dose use. Patients with pre-existing hearing loss or renal impairment are at increased risk.
**Correct Answer:** C.