Acute respiratory distress during paradoxical reaction to antituberculous therapy in an 8-month-old child

Shah, Ira; Chilkar, Sujeet; Patil, Manisha; Ali, Uma

doi:10.4103/0970-2113.102840

Cited by 6 publications

(4 citation statements)

References 5 publications

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“…Most paradoxical reactions respond to a course of steroids probably due to suppression of the inflammatory responses. 1,7,8 Our patient had a dramatic response to steroid therapy taken over a period of 2 months while continuing the same ATT.…”

Section: Case Reportmentioning

confidence: 70%

Congenital Tuberculosis with Paradoxical Reaction

Sakaria

Shah²

2023

Pediatric Oncall

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Paradoxical reactions with congenital tuberculosis (TB) are rare. We hereby report a case of 5 month old premature infant with progressive pulmonary tuberculosis who developed paradoxical reaction in the form of increasing respiratory distress after 3 months of Anti-Tuberculosis Therapy (ATT). The condition responded favorably to a high dose course of steroids taken over a period of 2 months with the ATT remaining unaltered.

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Section: Case Reportmentioning

confidence: 70%

Congenital Tuberculosis with Paradoxical Reaction

Sakaria

Shah²

2023

Pediatric Oncall

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“…According to the relevant literature, when diagnosis of TL is established and adequate anti-TB regimen is administered, a relapse in adenitis or appearance of draining sinuses could be expected and managed by adding oral steroids along with the anti-TB medication [32], despite steroids not being prescribed for TL treatment [34], except for local discomfort [20]. The use of corticosteroids while receiving therapy for TL seems to resolve paradoxical reaction and improves the clinical outcome [30, 35–39]. Although steroids seem to be particularly effective against paradoxical reaction during appropriate treatment for intracranial tuberculomas [21, 32], TB meningitis [40], and pleural TB [41], another study showed no significant clinical response [42].…”

Section: Discussionmentioning

confidence: 99%

Left Lateral Cervical Mass with Draining Sinuses

Michaelides

Bablekos

Michailidis

et al. 2019

Case Reports in Medicine

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The aim of the present study is to describe an uncommon case of tuberculous lymphadenitis (TL) in a symptomless 89-year-old male smoker patient, who presented at the emergency department of our hospital with left lateral cervical swelling with draining sinuses. No other clinical symptoms or physical findings were observed at admission. An elevated erythrocyte sedimentation rate (ESR) and a small calcified nodule in chest CT were the only abnormal findings. Pus samples from sinuses were examined and confirmed tuberculosis which was in agreement with surgical pathology of lymph nodes. A four- (4-) drug antituberculous regimen was administered. After an initial remission of his symptoms, the patient presented an exacerbation of the cervical swelling with draining sinuses necessitating addition of oral steroids. TL can be symptomless presenting a paradoxical reaction during treatment. The uniqueness of our case lies in the patient’s advanced age, which is uncommon with cervical lymphadenopathy as a form of extrapulmonary tuberculosis, as well as in the administration of oral steroids to resolve the neck’s clinical deterioration. The patient had a complete recovery and was free of disease after completion of his six-month antituberculous chemotherapy.

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“…Dans la pratique, la réaction paradoxale est un diagnostic d'exclusion. Toute exacerbation du tableau clinique chez un patient déjà sous anti-tuberculeux doit systématiquement faire rechercher une pathologie intercurrente, une résistance aux anti-tuberculeux ou une inobservance thérapeutique [16]. Une fois retenu, la conduite thérapeutique consiste à maintenir les anti-tuberculeux initiaux.…”

Section: Discussionunclassified

Tuberculose intestinale révélée par une occlusion intestinale aigüe au cours d’une réaction paradoxale au traitement anti-tuberculeux chez un patient immunocompétent: à propos d’un cas et revue de la littérature

Shinga¹,

Dièye²,

Badiane³

et al. 2019

Pan Afr Med J

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La tuberculose intestinale représente 3 à 5% de toutes les localisations viscérales. Malgré l'efficacité démontrée des anti-tuberculeux, des cas d'exacerbation du tableau clinique initial ont été décrits à l'initiation du traitement. Ces réactions dites «paradoxales» sont cependant rarement rapportées chez les immunocompétents et beaucoup moins sous forme d'occlusion intestinale. Nous rapportons un cas de tuberculose intestinale révélée par une occlusion intestinale aigüe au cours d'une réaction paradoxale aux anti-tuberculeux. Il s'agit d'un patient de 26 ans, immunocompétent qui a présenté un syndrome occlusif à un mois de traitement d'une tuberculose pleuro-pulmonaire. La tomodensitométrie (TDM) abdominale était en faveur d'une occlusion intestinale grêlique. La laparotomie objectivait une masse intra-péritonéale avec de multiples adhérences. L'examen anatomopathologique de la pièce opératoire était en faveur d'une tuberculose intestinale. L'évolution était favorable après la poursuite du traitement anti-tuberculeux initial.

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Acute respiratory distress during paradoxical reaction to antituberculous therapy in an 8-month-old child

Cited by 6 publications

References 5 publications

Congenital Tuberculosis with Paradoxical Reaction

Congenital Tuberculosis with Paradoxical Reaction

Left Lateral Cervical Mass with Draining Sinuses

Tuberculose intestinale révélée par une occlusion intestinale aigüe au cours d’une réaction paradoxale au traitement anti-tuberculeux chez un patient immunocompétent: à propos d’un cas et revue de la littérature

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