Paradoxical reaction in immunocompetent children with tuberculosis
| Autor: | Begoña Carazo Gallego, David Moreno-Pérez, Esmeralda Nuñez Cuadros, Alba Mesa Fernandez, María Martin Cantero, Pablo Obando Pacheco, Antonio Urda Cardona |
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| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: | |
| Zdroj: | International Journal of Infectious Diseases, Vol 51, Iss C, Pp 15-18 (2016) |
| Druh dokumentu: | article |
| ISSN: | 1201-9712 1878-3511 |
| DOI: | 10.1016/j.ijid.2016.08.009 |
| Popis: | Background: A paradoxical reaction (PR) during anti-tuberculosis treatment is a phenomenon that is poorly studied in immunocompetent children. It is defined as a clinical or radiological worsening of pre-existing tuberculosis (TB) disease. Methods: A retrospective descriptive study of children younger than 14 years of age was performed; these children developed PR during the years 2009 to 2014, following a diagnosis of TB. Demographic characteristics, microbiological results, treatment and outcome data were collected. Results: Of 51 children diagnosed with TB, five (9.8%) developed a PR; four of these children had pulmonary TB and the remaining patient had miliary TB with central nervous system involvement. The PR occurred at a median of 42 days (range 23–53 days) after initiating therapy. Corticosteroids were started when PR was suspected, at a median dose of 1 mg/kg/day. Clinical and radiological improvement was noted in all cases, with a median clinical regression time of 10.5 days (range 3–15 days) and a median radiological regression time of 45 days (range 26–105 days). No sequelae were described in any patient. Conclusions: PR in immunocompetent children during anti-tuberculosis treatment is not such an unusual reaction. Treatment with corticosteroids may be useful for the resolution of PR. |
| Databáze: | Directory of Open Access Journals |
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