New onset of fever and lymphadenopathy in a patient on antitubercular treatment for tuberculous meningitis: Drug resistance or paradoxical response phenomenon?
| Autor: | D. Majumdar, S. Chakraborty, A. Naskar, M. K. Ghosh, B. Saha |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: | |
| Zdroj: | Sri Lankan Journal of Infectious Diseases, Vol 7, Iss 1, Pp 58-62 (2017) |
| Druh dokumentu: | article |
| ISSN: | 2012-8169 2448-9654 |
| DOI: | 10.4038/sljid.v7i1.8123 |
| Popis: | Central nervous system (CNS) involvement is one of the most devastating clinical manifestations of tuberculosis (TB) noted in 5 to 10% of patients with extra pulmonary TB and accounts for approximately 1% of all patients with TB. Clinical deterioration during treatment with anti-tuberculosis drugs (ATD) is not uncommon in immunocompetent persons. Possibilities include multi-drug resistant tuberculosis (MDR-TB), a paradoxical response or some other non-tubercularcauses of fever. Corticosteroids are considered tohave a beneficial effect in the management of paradoxical reactions. Immuno-modulatory drugs, including tumour necrosis factor-α antagonists, thalidomide and interferon-γ have beenused in isolated cases with more severe forms of paradoxical reactions.We report here a case of a 13 year old girl who while being treated for tubercular meningitis, developed high grade fever with lymphadenopathy. Her lymph node biopsy showed caseous necrosis with presence of AFB suggestive of a paradoxical reaction. |
| Databáze: | Directory of Open Access Journals |
| Externí odkaz: |
|