[Exacerbation of pulmonary tuberculosis during chemotherapy]

Progression of a tuberculosis process during antituberculous therapy is most commonly evoked by its inadequacy. The latter may be associated with undiagnosed drug resistance, patients' incompliance due to the lack of their consciousness or discipline. In these circumstances, the use of stimulating pathogenetic treatments can provoke an exacerbation. Decreased immune defense mechanisms after experienced intercurrent infections may also serve as one of the common causes of tuberculosis exacerbations. Only in rare cases, progression of clinical and X-ray symptoms is explained by the massive pathogen lysis syndrome (Jarisch-Herxheimer's syndrome) The management policy for these patients should be different due to the causes of exacerbations.