Tuberculous Subcutaneous Abscesses Developing during Chemotherapy for Pulmonary Tuberculosis

Chen, Chung-Hua; Tsai, Jaw‐Ji; Shih, Jen‐Fu; Perng, Reury-Perng

doi:10.1080/00365549309169685

Cited by 10 publications

(3 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…To our knowledge, besides our case, 28 cases of a PR in miliary tuberculosis in non-HIV-infected patients have been reported in the past 40 years (Table 1) [[7], [8], [9], [10], [11], [12], [13], [14], [15], [16], [17], [18], [19], [20], [21], [22], [23], [24], [25], [26], [27], [28], [29], [30], [31], [32]]. The manifestations described depended on the site of involvement.…”

Section: Discussionmentioning

confidence: 66%

Ground-glass opacity as a paradoxical reaction in miliary tuberculosis: A case report and review of the literature

Tokuyama

Matsumoto

Kusakabe

et al. 2020

IDCases

View full text Add to dashboard Cite

A paradoxical reaction (PR) is an excessive immune response occurring during antitubercular therapy (ATT), but is rare in patients with miliary tuberculosis. A 78-year-old woman complained of general malaise, loss of appetite, and fever for 10 days. Chest computed tomography (CT) showed diffuse, bilateral, discrete miliary nodules. The patient was treated with ATT for miliary tuberculosis. Nine days after starting the treatment, she developed a spiking fever and worsening malaise. Repeat CT showed new localized ground-glass opacity (GGO) in the right upper lobe. After excluding possible etiologies, she was diagnosed with PR due to ATT. She was successfully managed with oral prednisolone while continuing ATT. The GGO diminished and did not recur after discontinuation of the steroids. We reviewed 28 reported cases of miliary tuberculosis with a PR in patients not infected with human immunodeficiency virus. Those not on immunosuppressive therapy were likely to develop a PR early. This case illustrates that a PR may present as localized GGO in miliary tuberculosis in the lung of patients treated with ATT. In cases of a PR with marked symptoms, steroid therapy may be valuable.

show abstract

Section: Discussionmentioning

confidence: 66%

Ground-glass opacity as a paradoxical reaction in miliary tuberculosis: A case report and review of the literature

Tokuyama

Matsumoto

Kusakabe

et al. 2020

IDCases

View full text Add to dashboard Cite

show abstract

“…Including the two cases presented here, a total of 143 episodes of paradoxical response was found in the English literature, of which 122 episodes in 104 patients matched our definition (Table 1) [4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,…”

Section: Literature Reviewmentioning

confidence: 89%

“…For lesions in superficial sites, such as peripheral lymph nodes [6,23,42,43], skin and soft tissues [44,45,46,47,48], and bone and tendons [36,43,49], the clinical symptoms of paradoxical deterioration are usually obvious. Involvement of lymph nodes during paradoxical deterioration (4%) in our series was significantly less common than that in HIV-positive patients (41%) [57].…”

Section: Discussionmentioning

confidence: 99%

Clinical Spectrum of Paradoxical Deterioration During Antituberculosis Therapy in Non-HIV-Infected Patients

Cheng

Lee

et al. 2002

European Journal of Clinical Microbiology & Infectious Dise

305

233

View full text Add to dashboard Cite

Paradoxical deterioration during antituberculosis therapy, defined as the clinical or radiological worsening of pre-existing tuberculous lesions or the development of new lesions in a patient who initially improves, remains a diagnostic dilemma. Although different clinical presentations of paradoxical response have been described, a systematic analysis of the entity in non-HIV-infected patients is lacking. Reported here are two cases of paradoxical deterioration in which sequential changes in lymphocyte counts and tuberculin skin test results are emphasized. In addition, 120 episodes of paradoxical response after antituberculosis treatment were reviewed. Of the total 122 episodes, 101 (82.8%) were associated with extrapulmonary tuberculosis. The median time from commencement of treatment to paradoxical deterioration was 60 days. The median time to onset of central nervous system manifestations (63 days) was longer than the time to onset of manifestations at other sites (56 days) ( P=0.02). Development of new lesions in anatomical sites other than those observed at initial presentation was observed in 31 (25.4%) episodes. A surge in the lymphocyte count, accompanied by an exaggerated tuberculin skin reaction, was observed in our patients during the paradoxical deterioration, analogous to the findings in HIV-positive patients. Treatment of the paradoxical response included surgical intervention (60.7%) and administration of steroids (39.3%). The use of steroids appeared to be safe in this series, as 95% of the Mycobacterium tuberculosis isolates were susceptible to first-line antituberculosis therapy.

show abstract

Paradoxical psoas and subcutaneous abscesses developing on anti-tuberculous treatment: A case report and literature review

Kaya¹,

Altınkaynak²,

Keskin³

et al. 2023

Journal of the National Medical Association

View full text Add to dashboard Cite

Tuberculous Subcutaneous Abscesses Developing during Chemotherapy for Pulmonary Tuberculosis

Cited by 10 publications

References 9 publications

Ground-glass opacity as a paradoxical reaction in miliary tuberculosis: A case report and review of the literature

Ground-glass opacity as a paradoxical reaction in miliary tuberculosis: A case report and review of the literature

Clinical Spectrum of Paradoxical Deterioration During Antituberculosis Therapy in Non-HIV-Infected Patients

Paradoxical psoas and subcutaneous abscesses developing on anti-tuberculous treatment: A case report and literature review

Contact Info

Product

Resources

About