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Paradoxical response to antitubercular drugs
S Kumar1, V Puri, M M Mehndiratta
1Department of Neurosurgery, Neurology and Radiology, G.B. Pant Hospital, New Delhi.
Indian Journal of Pediatrics
|November 1, 1995
Summary
Paradoxical worsening of tuberculosis lesions, including new intracranial tuberculomas and enlarged existing ones, occurred in seven patients despite antitubercular drug treatment. Continued therapy with pyrazinamide addition led to positive outcomes.
Area of Science:
- Neurology
- Infectious Diseases
- Radiology
Background:
- Tuberculosis (TB) is a significant global health challenge.
- Antitubercular drugs are the cornerstone of TB treatment.
- Paradoxical reactions can complicate TB therapy.
Observation:
- Seven patients presented with paradoxical responses during antitubercular treatment.
- New intracranial tuberculomas appeared in three patients.
- Existing tuberculomas enlarged in two patients.
- Multiple tuberculomas emerged in two patients with tubercular meningitis.
Findings:
- Clinical symptoms worsened in all affected patients.
- Computed tomography (CT) and magnetic resonance imaging (MRI) confirmed new or enlarged lesions.
- These findings indicated a paradoxical response to antitubercular drugs.
Implications:
- Paradoxical reactions require careful monitoring in TB patients.
- Continued conservative management, potentially with added pyrazinamide, can be effective.
- Understanding paradoxical responses is crucial for optimizing TB treatment strategies.