24Aug 2018

PARADOXICAL REACTION INDUCED BY ANTITUBERCULOUS DRUGS IN NON-HIV INFECTED PATIENT.

  • Service de Neurologie, H?pital Militaire d?Instruction Mohammed V, Rabat, Maroc.
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Introduction: Neuromeningeal tuberculosis of deleterious, paradoxical, progression despite appropriate antibiotic therapy is rare. Observation: An immunocompetent patient with tuberculous meningitis. The paradoxical evolution under well - conducted bacillary treatment associated with corticosteroid therapy was marked by the appearance of multiple cerebral abscesses in different topography. Discussion: During anti-tuberculosis therapy clinical worsening is rare, particularly when it occurs in an immunocompetent patient. This possibility should be systematically evoked in such cases. The explanation of this phenomenon is still unclear.


  1. Choremis CB, Padiatellis C, Zou Mbou Lakis D, Yannakos D. Transitory exacerbation of fever and roentgenographic findings during treatment of tuberculosis in children. Am Rev Tuberc 1955;72:527?36.
  2. Cheng VCC, Ho PL, Lee RA, Chan KS, Chan KK, Woo PC, et al. Clinical spectrum of paradoxical deterioration during antituberculosis therapy in non-HIV infected patients. Eur J Clin Microbiol Infect Dis 2002;21:803?9.
  3. M?an M, Pavese P, Blanc M, Leclercq P, Brion JP, Stahl JP. Reconstitution immunitaire et infections ? mycobact?ries sous traitement antir?troviral. Presse Med 2005;34:1511?4.
  4. Chambers ST, Hendrickse WA, Record C, Rudge P, Smith H. Paradoxical expansion of intracranial tuberculomas during chemotherapy. Lancet 1984;2: 181-3.
  5. Cheng VCC, Yam WC, Woo PCY, Lau SKP, Hung IFN, Wong SPY, et al. Risk factorsfor development of paradoxical response during antituberculosis therapy inHIV-negative patients. Eur J Clin Microbiol Infect Dis 2003;22:597?602.
  6. Narita M, Ashkin D, Hollender E, Pitchenik A. Paradoxical worsening of tuberculosis following antiretroviral therapy in patients with aids. Am J Resp Crit Care Med 1998;158:157?61.
  7. Hawkey CR, Yap T, Pereira J, Moore DA, Davidson RN, Pasvol G, et al. Characterization and management of paradoxical upgrading reactions in hiv-uninfected patients with lymph node tuberculosis. Clin Infect Dis 2005;40:1368?71.
  8. Breton G. Syndromes de reconstitution immune aspects cliniques, diagnostiques et th?rapeutiques. Med Mal Infect 2007;37:S2?5.
  9. Maes HH, Causse JE, Maes JF. Mycobacterial infections: are the observed enigmas and paradoxes explained by immunosuppression and immunodeficiency? Medical Hypotheses 1996;46:163?71.
  10. Leonard JM, Des Prez RM. Tuberculous meningitis. Infect Dis Clin North Am 1990; 4: 769-87
  11. Rao GP, Nadh BR, Hemaratnan A, Srinivas TV, Reddy PK. Paradoxical progression of tuberculous lesions during chemotherapy of central nervous system tuberculosis. J Neurosurg 1995; 83: 359-62
  12. Yang CH, Lin YT. Immune reconstitution associated hypercalcemia. Am J Emerg Med 2009;27:e629.
  13. Ohkouchi M, Inase N, Yasui M, Miura H. Case of pubic tuberculous osteomyelitis and pericarditis during antituberculosis chemotherapy. Kekkaku 2004;79:531?5.
  14. Teoh R, Humphries MJ, O?Mahony G. Symptomatic intracranial tuberculoma
  15. developing during treatment of tuberculosis: a report of 10 patients and review
  16. of the literature. Q J Med 1987;63:449?60.
  17. Cho OH, Park KH, Kim T, Song EH, Jang EY, Lee EJ, et al. Paradoxical responsesin non-HIV-infected patients with peripheral lymphnode tuberculosis. J Infect2009;59:56?61.

[Mohamed Amine MNAILI, Amine Raggabi, Mohamed Ajamat, Youssouf Benmouh and Ahmed Bourazza. (2018); PARADOXICAL REACTION INDUCED BY ANTITUBERCULOUS DRUGS IN NON-HIV INFECTED PATIENT. Int. J. of Adv. Res. 6 (Aug). 900-903] (ISSN 2320-5407). www.journalijar.com


Mohamed Amine MNAILI
Service de Neurologie, Hôpital Militaire d’Instruction Mohammed V, Rabat, Maroc

DOI:


Article DOI: 10.21474/IJAR01/7592      
DOI URL: https://dx.doi.org/10.21474/IJAR01/7592