Paradoxical response as a cervical lymph node enlargement after termination of anti-tuberculosis treatment in a patient with pulmonary tuberculosis
Abstract A paradoxical response is not uncommon in non-HIV-infected patients, particularly those with extra-pulmonary tuberculosis. It is defined as the radiological and clinical worsening of a previous lesion or the development of new lesion during anti-tuberculosis therapy. The paradoxical respons...
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| Format: | Article |
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Kosin University College of Medicine
2016-06-01
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| Series: | Kosin Medical Journal |
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| Online Access: | http://www.kosinmedj.org/upload/pdf/ksmc031-01-08.pdf |
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| author | Hye-Rim Kang Ho Young Lee Mi-Yeong Kim Young Min Lee Soo Jin Jung Hyun-Kyung Lee Si Hyeong Lee Yunmi Kim |
| author_facet | Hye-Rim Kang Ho Young Lee Mi-Yeong Kim Young Min Lee Soo Jin Jung Hyun-Kyung Lee Si Hyeong Lee Yunmi Kim |
| author_sort | Hye-Rim Kang |
| collection | DOAJ |
| description | Abstract A paradoxical response is not uncommon in non-HIV-infected patients, particularly those with extra-pulmonary tuberculosis. It is defined as the radiological and clinical worsening of a previous lesion or the development of new lesion during anti-tuberculosis therapy. The paradoxical response has been attributed to host immunologic reactions, such as a delayed hypersensitivity or a response to mycobacterial antigens. In most reports of paradoxical response, these responses occurred in the same location as a previous lesion. In this patient with pulmonary tuberculosis, cervical lymph node enlargement occurred as a paradoxical response after the completion of anti-tuberculosis treatment. Although the new lesion developed in another location, it could be considered as a paradoxical response based on the negative culture result of acid fast bacilli from the new lesion and drug sensitivity result from initial bronchoalveolar lavage specimen. Therefore we were able to decide on the termination of unnecessary anti-tuberculous treatment. Based on our case, we can conclude that paradoxical response can occur after the termination of anti-tuberculosis therapy even in new site. |
| first_indexed | 2024-04-12T17:29:19Z |
| format | Article |
| id | doaj.art-93411f1a686348088914cb36188d822d |
| institution | Directory Open Access Journal |
| issn | 2005-9531 2586-7024 |
| language | English |
| last_indexed | 2024-04-12T17:29:19Z |
| publishDate | 2016-06-01 |
| publisher | Kosin University College of Medicine |
| record_format | Article |
| series | Kosin Medical Journal |
| spelling | doaj.art-93411f1a686348088914cb36188d822d2022-12-22T03:23:11ZengKosin University College of MedicineKosin Medical Journal2005-95312586-70242016-06-01311717810.7180/kmj.2016.31.1.711169Paradoxical response as a cervical lymph node enlargement after termination of anti-tuberculosis treatment in a patient with pulmonary tuberculosisHye-Rim Kang0Ho Young Lee1Mi-Yeong Kim2Young Min Lee3Soo Jin Jung4Hyun-Kyung Lee5Si Hyeong Lee6Yunmi Kim7Department of Internal Medicine, Busan Paik Hospital, College of Medicine, Inje University, Busan, KoreaDepartment of Internal Medicine, Busan Paik Hospital, College of Medicine, Inje University, Busan, KoreaDepartment of Internal Medicine, Busan Paik Hospital, College of Medicine, Inje University, Busan, KoreaDepartment of Internal Medicine, Busan Paik Hospital, College of Medicine, Inje University, Busan, KoreaDepartment of Pathology, Busan Paik Hospital, College of Medicine, Inje University, Busan, KoreaDepartment of Internal Medicine, Busan Paik Hospital, College of Medicine, Inje University, Busan, KoreaDepartment of Internal Medicine, Busan Paik Hospital, College of Medicine, Inje University, Busan, KoreaDepartment of Internal Medicine, Busan Paik Hospital, College of Medicine, Inje University, Busan, KoreaAbstract A paradoxical response is not uncommon in non-HIV-infected patients, particularly those with extra-pulmonary tuberculosis. It is defined as the radiological and clinical worsening of a previous lesion or the development of new lesion during anti-tuberculosis therapy. The paradoxical response has been attributed to host immunologic reactions, such as a delayed hypersensitivity or a response to mycobacterial antigens. In most reports of paradoxical response, these responses occurred in the same location as a previous lesion. In this patient with pulmonary tuberculosis, cervical lymph node enlargement occurred as a paradoxical response after the completion of anti-tuberculosis treatment. Although the new lesion developed in another location, it could be considered as a paradoxical response based on the negative culture result of acid fast bacilli from the new lesion and drug sensitivity result from initial bronchoalveolar lavage specimen. Therefore we were able to decide on the termination of unnecessary anti-tuberculous treatment. Based on our case, we can conclude that paradoxical response can occur after the termination of anti-tuberculosis therapy even in new site.http://www.kosinmedj.org/upload/pdf/ksmc031-01-08.pdfdiagnosisextra-pulmonary tuberculosisparadoxical response |
| spellingShingle | Hye-Rim Kang Ho Young Lee Mi-Yeong Kim Young Min Lee Soo Jin Jung Hyun-Kyung Lee Si Hyeong Lee Yunmi Kim Paradoxical response as a cervical lymph node enlargement after termination of anti-tuberculosis treatment in a patient with pulmonary tuberculosis Kosin Medical Journal diagnosis extra-pulmonary tuberculosis paradoxical response |
| title | Paradoxical response as a cervical lymph node enlargement after termination of anti-tuberculosis treatment in a patient with pulmonary tuberculosis |
| title_full | Paradoxical response as a cervical lymph node enlargement after termination of anti-tuberculosis treatment in a patient with pulmonary tuberculosis |
| title_fullStr | Paradoxical response as a cervical lymph node enlargement after termination of anti-tuberculosis treatment in a patient with pulmonary tuberculosis |
| title_full_unstemmed | Paradoxical response as a cervical lymph node enlargement after termination of anti-tuberculosis treatment in a patient with pulmonary tuberculosis |
| title_short | Paradoxical response as a cervical lymph node enlargement after termination of anti-tuberculosis treatment in a patient with pulmonary tuberculosis |
| title_sort | paradoxical response as a cervical lymph node enlargement after termination of anti tuberculosis treatment in a patient with pulmonary tuberculosis |
| topic | diagnosis extra-pulmonary tuberculosis paradoxical response |
| url | http://www.kosinmedj.org/upload/pdf/ksmc031-01-08.pdf |
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