Case Reports
New onset of fever and lymphadenopathy in a patient on antitubercular treatment for tuberculous meningitis: Drug resistance or paradoxical response phenomenon?
Authors:
D. Majumdar ,
School of Tropical Medicine, Kolkata, IN
About D.
Department of Tropical Medicine
S. Chakraborty,
School of Tropical Medicine, Kolkata, IN
About S.
Department of Tropical Medicine
A. Naskar,
School of Tropical Medicine, Kolkata, IN
About A.
Department of Tropical Medicine
M. K. Ghosh,
School of Tropical Medicine, Kolkata, IN
About M. K.
Department of Tropical Medicine
B. Saha
School of Tropical Medicine, Kolkata, IN
About B.
Department of Tropical Medicine
Abstract
Central nervous system (CNS) involvement is one of the most devastating clinical manifestations of tuberculosis (TB) noted in 5 to 10% of patients with extra pulmonary TB and accounts for approximately 1% of all patients with TB. Clinical deterioration during treatment with anti-tuberculosis drugs (ATD) is not uncommon in immunocompetent persons. Possibilities include multi-drug resistant tuberculosis (MDR-TB), a paradoxical response or some other non-tubercularcauses of fever. Corticosteroids are considered tohave a beneficial effect in the management of paradoxical reactions. Immuno-modulatory drugs, including tumour necrosis factor-α antagonists, thalidomide and interferon-γ have beenused in isolated cases with more severe forms of paradoxical reactions.We report here a case of a 13 year old girl who while being treated for tubercular meningitis, developed high grade fever with lymphadenopathy. Her lymph node biopsy showed caseous necrosis with presence of AFB suggestive of a paradoxical reaction.
How to Cite:
Majumdar, D., Chakraborty, S., Naskar, A., Ghosh, M.K. and Saha, B., 2017. New onset of fever and lymphadenopathy in a patient on antitubercular treatment for tuberculous meningitis: Drug resistance or paradoxical response phenomenon?. Sri Lankan Journal of Infectious Diseases, 7(1), pp.58–62. DOI: http://doi.org/10.4038/sljid.v7i1.8123
Published on
04 May 2017.
Peer Reviewed
Downloads
