Paradoxical reactions in non-HIV tuberculosis presenting as endobronchial obstruction

Bloch, Susannah; Wickremasinghe, M; Wright, A.; Rice, Alfred G.; Thompson, M.; Kon, Onn Min

doi:10.1183/09059180.00003709

Cited by 24 publications

(20 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, diagnosis is challenging; a change in the size of ulcers on an uneven surface such as that of a limb is difficult to record, and erythema is easily missed on black African skin. By analogy with other diseases such as tuberculosis, these reactions are thought to result from increasing inflammation as a consequence of enhancement of the immune response during treatment (28)(29)(30)(31). In the present study, paradoxical reactions were observed in 9% of patients with all forms of Buruli ulcer disease from week 4 during antibiotic treatment up to week 32, 24 weeks after treatment finished.…”

Section: Discussionmentioning

confidence: 66%

Clinical and Bacteriological Efficacy of Rifampin-Streptomycin Combination for Two Weeks followed by Rifampin and Clarithromycin for Six Weeks for Treatment of Mycobacterium ulcerans Disease

Phillips

Sarfo

Abass

et al. 2014

Antimicrob Agents Chemother

View full text Add to dashboard Cite

Buruli ulcer, an ulcerating skin disease caused by Mycobacterium ulcerans infection, is common in tropical areas of western Africa. We determined the clinical and microbiological responses to administration of rifampin and streptomycin for 2 weeks followed by administration of rifampin and clarithromycin for 6 weeks in 43 patients with small laboratory-confirmed Buruli lesions and monitored for recurrence-free healing. Bacterial load in tissue samples before and after treatment for 6 and 12 weeks was monitored by semiquantitative culture. The success rate was 93%, and there was no recurrence after a 12-month follow-up. Eight percent had a positive culture 4 weeks after antibiotic treatment, but their lesions went on to heal. The findings indicate that rifampin and clarithromycin can replace rifampin and streptomycin for the continuation phase after rifampin and streptomycin administration for 2 weeks without any apparent loss of efficacy.

show abstract

Section: Discussionmentioning

confidence: 66%

Clinical and Bacteriological Efficacy of Rifampin-Streptomycin Combination for Two Weeks followed by Rifampin and Clarithromycin for Six Weeks for Treatment of Mycobacterium ulcerans Disease

Phillips

Sarfo

Abass

et al. 2014

Antimicrob Agents Chemother

View full text Add to dashboard Cite

show abstract

“…Bu nedenle PR şüphesi olduğunda, tedavi uyumsuzluğu, ilaç direnci, hastalığın progresyonu ve sekonder sebepler mutlaka ekarte edilmelidir. [12] Olgumuz ilaçlarını düzenli olarak kullandığından, tedavi uyumsuzluğu düşünülmedi. Ancak hastaneye başvuru sırasında ayırıcı tanıda düşünülen malignite veya diğer enfeksiyonlar yeniden gözden geçirildi.…”

Section: Discussionunclassified

Recurrent paradoxical reaction in a patient with tuberculous meningitis and intracranial tuberculomas

Yaşar¹,

Pehlivanoğlu²,

İnce³

et al. 2011

Istanbul Tip Derg

View full text Add to dashboard Cite

ÖZETTüberküloz menenjit (TBM) tüberkülozun az görülen ancak, en ciddi seyirli formudur. TBM'nin en sık intrakranyal bulgusu tüberkülomdur. Tüberküloz için pozitif aile öyküsü ve eşlik eden miliyer akciğer tüberkülozu olan TBM'li 23 yaşındaki kadın olguda, yaygın intrakranyal tüberkülom ve gözde korioretinit odakları "Rich nodülleri" mevcuttu. Antitüberküloz tedavisinin 1., 2. ve 4. aylarında tedaviye rağmen mevcut tüberkülomlarda ve ödemde progresyon ve yeni gelişen tüberkülomlar saptandı, tekrarlayan paradoksik reaksiyon olarak değerlendirildi. Steroid tedavisi ile tüberkülom boyutları ve çevresindeki ödem geriledi. TBM'li olgularda tedavi altında ortaya çıkabilen paradoksik reaksiyonu gözden kaçırmamak için hastaların belirli aralıklarla klinik ve radyolojik olarak takip edilmeleri önemlidir.Anahtar sözcükler: Paradoksik reaksiyon; tüberkülom; tüberküloz menenjit; tüberküloz. SUMMARYTuberculous meningitis (TBM) is a rare but the most severe form of tuberculosis (TB). Tuberculoma is the most common intracranial finding in TBM. A 23-year-old female with a family history for TB and miliary TB and TBM presented with multiple intracranial tuberculomas and chorioretinitis "Rich foci" in eyes. The progression of the old tuberculomas and edema and presence of new tuberculomas during antituberculous treatment in months 1, 2 and 4 were evaluated as recurrent paradoxical reaction. The size of tuberculomas and edema regressed with prolonged steroid treatment. Clinical and radiological follow-up of patients with TBM is important to predict paradoxical reaction.

show abstract

“…4g, 4h) is rare. It can either be a newly developed paradoxical lymphadenitis with erosion or fistulation into the airways or a true de novo endobronchial paradoxical reaction (15).…”

Section: Clinical and Radiologic Manifestations Of Tb-irismentioning

confidence: 99%

“…Systemic corticosteroid administration for 4-6 weeks has been shown to be effective in HIV, symptomatic enlarging intracranial tuberculoma (16), and endobronchial obstruction (15), since it may reduce proinflammatory cytokines (16,17). However, its role in other forms of TB-IRIS remains unclear.…”

Section: Treatment and Outcomesmentioning

confidence: 99%

Thoracic manifestations of paradoxical immune reconstitution inflammatory syndrome during or after antituberculous therapy in HIV-negative patients

Pornsuriyasak

Suwatanapongched²

2015

Diagn Interv Radiol

View full text Add to dashboard Cite

Immune reconstitution inflammatory syndrome (IRIS) is a consequence of exaggerated and dysregulated host's inflammatory response to invading microorganism, leading to uncontrolled inflammatory reactions. IRIS associated with tuberculosis (TB) is well recognized among human immunodeficiency virus (HIV)-infected patients receiving highly active antiretroviral therapy, but it is less common among HIV-negative patients. IRIS can manifest as a paradoxical worsening or recurring of preexisting tuberculous lesions or development of new lesions despite successful antituberculous treatment. Hence, the condition might be misdiagnosed as superimposed infections, treatment failure, or relapse of TB. This pictorial essay reviewed diagnostic criteria and various thoracic manifestations of the paradoxical form of TB-associated IRIS (TB-IRIS) that might aid in early recognition of this clinical entity among HIV-negative patients. The treatment and outcomes of TB-IRIS were also discussed.

show abstract

Paradoxical reactions in non-HIV tuberculosis presenting as endobronchial obstruction

Cited by 24 publications

References 3 publications

Clinical and Bacteriological Efficacy of Rifampin-Streptomycin Combination for Two Weeks followed by Rifampin and Clarithromycin for Six Weeks for Treatment of Mycobacterium ulcerans Disease

Clinical and Bacteriological Efficacy of Rifampin-Streptomycin Combination for Two Weeks followed by Rifampin and Clarithromycin for Six Weeks for Treatment of Mycobacterium ulcerans Disease

Recurrent paradoxical reaction in a patient with tuberculous meningitis and intracranial tuberculomas

Thoracic manifestations of paradoxical immune reconstitution inflammatory syndrome during or after antituberculous therapy in HIV-negative patients

Contact Info

Product

Resources

About