We report a case of pulmonary tuberculosis who developed tuberculous mediastinal and later cervical lymphadenopathy while on antituberculous chemotherapy. She responded to the addition of oral corticosteroids to her regimen. The relevant literature regarding the pathogenesis, varied manifestations and the clinical importance of recognising a paradoxical response is discussed.

Keywords:
Tuberculosis, Lymphatic, Paradoxical response, Corticosteroids, chemotherapy
1.
Smith H: Paradoxical responses during the chemotherapy of tuberculosis. J Infect 1987;15: 1–3.
2.
Gupta RC, Dixit R, Purohit SD, Saxena A: Development of pleural effusion in patients during antituberculous chemotherapy: Analysis of twenty-nine cases with review of literature. Indian J Chest Dis Allied Sci 2000;42:161–166.
3.
Campbell IA, Dyson AJ: Lymphnode tuberculosis. A comparison of various methods of treatment. Tubercle 1977;58:171–179.
4.
Minguez C, Roca B, Gonzalez-Mino C, Simon E: Superior vena cava syndrome during the treatment of pulmonary tuberculosis in an HIV-1 infected patient. J Infect 2000;40:187–189.
5.
Dyer RA, Chappel WA, Potgieter PD: Adult respiratory distress syndrome associated with miliary tuberculosis. Crit Care Med 1985;13:12–15.
6.
Mert A, Bilir M, Ozturk R, Tabak F, Ozaras R, Tahan V, Senturk H, Aktuglu Y: Tuberculous subcutaneous abscesses developing during miliary tuberculosis therapy. Scand J Infect Dis 2000;32:37–40.
7.
Rodriguez-Bano J, Muniain MA, Aznar J, Perez-Cano R, Corral JL: Systemic paradoxical response to antituberculous drugs: Resolution with corticosteroid therapy. Clin Infect Dis 1997;24:517–519.
8.
Boumpas DT, Chrousos GP, Wilder RL, Cupps TR, Balow JE: Glucocorticoid therapy for immune-mediated diseases: Basic and clinical correlates. Ann Intern Med 1993;119:1198–1208.
9.
Bukharie H: Paradoxical response to antituberculous drugs: Resolution with corticosteroid therapy. Scand J Infect Dis 2000;32:96–97.
© 2003 S. Karger AG, Basel
2003
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