[A Case of Paradoxical Reaction Development during Antituberculosis Therapy]

Area of Science:

• Immunology
• Infectious Diseases
• Pulmonology

Background:

• Tuberculosis (TB) remains a significant global health challenge.
• Antituberculosis therapy (ATT) can sometimes trigger paradoxical reactions.
• Paradoxical reactions manifest as worsening or new tuberculous lesions despite treatment.

Observation:

• A 24-year-old female with abdominal and pulmonary TB experienced fever and abdominal pain after 4 months of ATT.
• Abdominal CT revealed tuberculous mesenteric lymphadenitis and an enlarged necrotic abscess.
• Symptoms persisted despite surgical intervention (adhesiolysis and abscess drainage).

Findings:

• The patient's condition was attributed to a paradoxical reaction, not treatment failure.
• Combined corticosteroid and ATT administration resulted in complete recovery.
• This case highlights the importance of recognizing paradoxical reactions in TB management.

Implications:

• Corticosteroids may be a crucial adjunct therapy for managing paradoxical reactions in TB.
• Early recognition and appropriate management of paradoxical reactions can improve patient outcomes.
• Further research into the mechanisms and optimal treatment of paradoxical reactions is warranted.