Yonsei Med J.  2008 Oct;49(5):853-856. 10.3349/ymj.2008.49.5.853.

Severe Paradoxical Reaction Requiring Tracheostomy in a Human Immunodeficiency Virus (HIV)-negative Patient with Cervical Lymph Node Tuberculosis

• Park IS
• Son D
• Lee C
• Park JE
• Lee JS
• Cheong MH
• Kim YM

• KMID: 2158206
• DOI: http://doi.org/10.3349/ymj.2008.49.5.853

Abstract

During drug treatment of tuberculous lymphadenitis, paradoxical response (PR) may occasionally occur. Continued treatment or lymph node aspiration improves PR without severe sequelae. However, we report a case of severe PR in a patient with cervical lymph node tuberculosis causing airway obstruction due to retropharyngeal lymph node swelling during antituberculous treatment. Tracheostomy and drainage of the node were performed to secure the airway. Possible airway obstruction due to PR must be suspected when cervical lymph node tuberculosis involves the retropharyngeal lymph node.

Keyword

Paradoxical reaction; lymph node; tuberculosis; tracheostomy

MeSH Terms

Adult
Female
*HIV Seronegativity
Humans
Tomography, X-Ray Computed
*Tracheostomy
Tuberculosis, Lymph Node/*complications/radiography/surgery

Figure

• 

  Fig. 1 (A) Enlarged necrotizing lymph nodes in the right retropharyngeal (white arrow) and neck level II (black arrows) spaces. (B) On admission, the retropharyngeal lymph node (arrow) was enlarged with central necrosis and obstructed the airway.

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