New onset of fever and lymphadenopathy in a patient on antitubercular treatment for tuberculous meningitis: Drug resistance or paradoxical response phenomenon?
<p>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-tuberculosi...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Sri Lankan Society for Microbiology
2017-05-01
|
| Series: | Sri Lankan Journal of Infectious Diseases |
| Subjects: | |
| Online Access: | https://sljid.sljol.info/articles/8123 |
| _version_ | 1811231886450622464 |
|---|---|
| author | D. Majumdar S. Chakraborty A. Naskar M. K. Ghosh B. Saha |
| author_facet | D. Majumdar S. Chakraborty A. Naskar M. K. Ghosh B. Saha |
| author_sort | D. Majumdar |
| collection | DOAJ |
| description | <p>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.</p> |
| first_indexed | 2024-04-12T10:52:28Z |
| format | Article |
| id | doaj.art-bd579ef9e1ac4ce09a8c3a2d864b2b8c |
| institution | Directory Open Access Journal |
| issn | 2012-8169 2448-9654 |
| language | English |
| last_indexed | 2024-04-12T10:52:28Z |
| publishDate | 2017-05-01 |
| publisher | Sri Lankan Society for Microbiology |
| record_format | Article |
| series | Sri Lankan Journal of Infectious Diseases |
| spelling | doaj.art-bd579ef9e1ac4ce09a8c3a2d864b2b8c2022-12-22T03:36:10ZengSri Lankan Society for MicrobiologySri Lankan Journal of Infectious Diseases2012-81692448-96542017-05-0171586210.4038/sljid.v7i1.81235730New onset of fever and lymphadenopathy in a patient on antitubercular treatment for tuberculous meningitis: Drug resistance or paradoxical response phenomenon?D. Majumdar0S. Chakraborty1A. Naskar2M. K. Ghosh3B. Saha4School of Tropical Medicine, KolkataSchool of Tropical Medicine, KolkataSchool of Tropical Medicine, KolkataSchool of Tropical Medicine, KolkataSchool of Tropical Medicine, Kolkata<p>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.</p>https://sljid.sljol.info/articles/8123paradoxical response, immunocompetent, tuberculosis, mdr tb |
| spellingShingle | D. Majumdar S. Chakraborty A. Naskar M. K. Ghosh B. Saha New onset of fever and lymphadenopathy in a patient on antitubercular treatment for tuberculous meningitis: Drug resistance or paradoxical response phenomenon? Sri Lankan Journal of Infectious Diseases paradoxical response, immunocompetent, tuberculosis, mdr tb |
| title | New onset of fever and lymphadenopathy in a patient on antitubercular treatment for tuberculous meningitis: Drug resistance or paradoxical response phenomenon? |
| title_full | New onset of fever and lymphadenopathy in a patient on antitubercular treatment for tuberculous meningitis: Drug resistance or paradoxical response phenomenon? |
| title_fullStr | New onset of fever and lymphadenopathy in a patient on antitubercular treatment for tuberculous meningitis: Drug resistance or paradoxical response phenomenon? |
| title_full_unstemmed | New onset of fever and lymphadenopathy in a patient on antitubercular treatment for tuberculous meningitis: Drug resistance or paradoxical response phenomenon? |
| title_short | New onset of fever and lymphadenopathy in a patient on antitubercular treatment for tuberculous meningitis: Drug resistance or paradoxical response phenomenon? |
| title_sort | new onset of fever and lymphadenopathy in a patient on antitubercular treatment for tuberculous meningitis drug resistance or paradoxical response phenomenon |
| topic | paradoxical response, immunocompetent, tuberculosis, mdr tb |
| url | https://sljid.sljol.info/articles/8123 |
| work_keys_str_mv | AT dmajumdar newonsetoffeverandlymphadenopathyinapatientonantituberculartreatmentfortuberculousmeningitisdrugresistanceorparadoxicalresponsephenomenon AT schakraborty newonsetoffeverandlymphadenopathyinapatientonantituberculartreatmentfortuberculousmeningitisdrugresistanceorparadoxicalresponsephenomenon AT anaskar newonsetoffeverandlymphadenopathyinapatientonantituberculartreatmentfortuberculousmeningitisdrugresistanceorparadoxicalresponsephenomenon AT mkghosh newonsetoffeverandlymphadenopathyinapatientonantituberculartreatmentfortuberculousmeningitisdrugresistanceorparadoxicalresponsephenomenon AT bsaha newonsetoffeverandlymphadenopathyinapatientonantituberculartreatmentfortuberculousmeningitisdrugresistanceorparadoxicalresponsephenomenon |