Pediatr Allergy Respir Dis.  2009 Mar;19(1):71-77.

Paradoxical Response to Chemotherapy in Tuberculous Pleural Effusion

Affiliations
  • 1Department of Pediatrics, College of Medicine, Hallym University, Seoul, Korea. drran@hallym.or.kr
  • 2Department of Pediatrics, College of Medicine, Ulsan University, Seoul, Korea.

Abstract

It is defined as the paradoxical response when the clinical or radiologic worsening of old lesions or the development of new lesion occur in spite of appropriate antituberculous therapy. The paradoxical response can occur as an intracranial tuberculoma, pleurisy, pericarditis and contralateral new parenchymal lesions. However, poor compliance with therapy, drug resistance, non-tuberculous mycobacterium, or another underlying condition as lung cancer should be ruled out before concluding that the treatment is the cause of the exacerbation. The case reports of paradoxical response have been mainly reported in adults, but extremely rare in children. We report a case of paradoxical response in which a new parenchymal lung lesion developed during antituberculous therapy in a 14-year-old female patient with tuberculous pleurisy. She experienced clinical improvement with steroid therapy in addition to antituberculous therapy.

Keyword

Tuberculosis; Pleural effusion; Chemotherapy
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