Paradoxical Deterioration During Anti-Tuberculous Therapy in Non-HIV-Infected Patients with Pleural Tuberculosis: A Pragmatic Approach

  • Luis Corral-Gudino Departamento de Medicina Interna, Hospital El Bierzo, Ponferrada, León http://orcid.org/0000-0003-0151-5420
  • Alicia Rivas-Lazamares Departamento de Medicina Interna, Hospital El Bierzo, Ponferrada, León
  • Ana Gonzalez-Fernandez Departamento de Medicina Interna, Hospital El Bierzo, Ponferrada, León
  • Juan Carlos Hernando-Garcia Departamento de Medicina Interna, Hospital El Bierzo, Ponferrada, León

Keywords

Pleural tuberculosis, antitubercular agents, paradoxical response

Abstract

We report a case of paradoxical deterioration. A male patient diagnosed with pleural tuberculosis, but who was not infected with human immunodeficiency virus (HIV), experienced clinical deterioration 3 weeks after the initiation of anti-tuberculous treatment. After other diagnoses were ruled out, a paradoxical response to treatment was established and the patient was started on systemic corticosteroids. Paradoxical response to treatment should be considered in patients with clinical deterioration after they start on anti-tuberculous treatment.

Author Biographies

Luis Corral-Gudino ,
Departamento de Medicina Interna, Hospital El Bierzo, Ponferrada, León Internal Medicine consultant.

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References

Cheng VC, 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;21:803–809.

Al-Majed SA. Study of paradoxical response to chemotherapy in tuberculous pleural effusion. Respir Med 1996;90:211–214.

Engel ME, Matchaba PT, Volmink J. Corticosteroids for tuberculous pleurisy. Cochrane Database Syst Rev 2007;4:CD001876.

Lai YF, Chao TY, Wang YH, Lin AS. Pigtail drainage in the treatment of tuberculous pleural effusions: a randomised study. Thorax 2003;58:149–151.

Bhuniya S, Arunabha DC, Choudhury S, Saha I, Roy TS, Saha M. Role of therapeutic thoracentesis in tuberculous pleural effusion. Ann Thorac Med 2012;7:215–219.

Published: 2016-09-28

Issue: Vol. 3 No. 6 (view)

Section: Articles

How to cite:
1.
Corral-Gudino L, Rivas-Lazamares A, Gonzalez-Fernandez A, Hernando-Garcia JC. Paradoxical Deterioration During Anti-Tuberculous Therapy in Non-HIV-Infected Patients with Pleural Tuberculosis: A Pragmatic Approach. EJCRIM [Internet]. 2016Sep.28 [cited 2020Sep.26];3(6). Available from: https://ejcrim.com/index.php/EJCRIM/article/view/475