Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Search in posts
Search in pages
Filter by Categories
Book Review
Brief Report
Case Letter
Case Report
Case Series
Commentary
Current Issue
Editorial
Erratum
Guest Editorial
Images
Images in Neurology
Images in Neuroscience
Images in Neurosciences
Letter to Editor
Letter to the Editor
Letters to Editor
Letters to the Editor
Media and News
None
Notice of Retraction
Obituary
Original Article
Point of View
Position Paper
Review Article
Short Communication
Systematic Review
Systematic Review Article
Technical Note
Techniques in Neurosurgery
Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Search in posts
Search in pages
Filter by Categories
Book Review
Brief Report
Case Letter
Case Report
Case Series
Commentary
Current Issue
Editorial
Erratum
Guest Editorial
Images
Images in Neurology
Images in Neuroscience
Images in Neurosciences
Letter to Editor
Letter to the Editor
Letters to Editor
Letters to the Editor
Media and News
None
Notice of Retraction
Obituary
Original Article
Point of View
Position Paper
Review Article
Short Communication
Systematic Review
Systematic Review Article
Technical Note
Techniques in Neurosurgery
Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Search in posts
Search in pages
Filter by Categories
Book Review
Brief Report
Case Letter
Case Report
Case Series
Commentary
Current Issue
Editorial
Erratum
Guest Editorial
Images
Images in Neurology
Images in Neuroscience
Images in Neurosciences
Letter to Editor
Letter to the Editor
Letters to Editor
Letters to the Editor
Media and News
None
Notice of Retraction
Obituary
Original Article
Point of View
Position Paper
Review Article
Short Communication
Systematic Review
Systematic Review Article
Technical Note
Techniques in Neurosurgery
View/Download PDF

Translate this page into:

Commentary
3 (
3
); 354-354

Commentary

Instituto de Medicina Experimental (IMEX)-CONICET,Academia Nacional de Medicina, Buenos Aires, Argentina

Address for correspondence: Dr. Luciana Balboa, Instituto de Medicina Experimental (IMEX)-CONICET, Academia Nacional de Medicina, Pacheco de Melo 3081, 1425, Buenos Aires, Argentina. E-mail: luciana_balboa@hotmail.com

Read COMMENTARY-ARTICLE associated with this -

Licence

This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Disclaimer:
This article was originally published by Medknow Publications & Media Pvt Ltd and was migrated to Scientific Scholar after the change of Publisher.

A paradoxical response is defined as the clinical or radiological worsening of pre-existing tuberculous lesions or the development of new lesions not attributable to the normal course of disease, in a patient who initially improved with antituberculosis therapy. Up to 10% patients with central nervous system tuberculosis report paradoxical response.[12] Among HIV-negative patients, symptomatic neurological deterioration may occur with the enlargement or appearance of intracranial tuberculomas during paradoxical response.[3]

Hence, there is an emerging need to recognize the deterioration resulting from paradoxical response rather than from treatment failure, drug resistance, or other infections. In this line, the article “Cerebral tuberculoma as a manifestation of paradoxical reaction in patients with pulmonary and extra-pulmonary tuberculosis: Case reports and review of literature”[4] represents an outlook towards this goal. This article focuses on a crucial challenge in tuberculosis management particularly in resource-limited settings, describing clinical features associated with cerebral tuberculomas as evidence of paradoxical reaction in five cases of HIV-negative patients with pulmonary and extra-pulmonary tuberculosis.

Given that these adverse events may result in the discontinuation of one or more antitubercular drugs, thereby limiting future therapeutic options and/or reducing adherence,[5] the differential diagnosis of paradoxical response as a cause of transient clinico-radiological deterioration in patients with tuberculosis becomes key for clinicians to recommend the best possible management.

References

  1. , , , , , , . Paradoxical reactions during tuberculosis treatment in patients with and without HIV co-infection. Thorax. 2004;59:704-7.
    [Google Scholar]
  2. , , , . Paradoxical response in patients with CNS tuberculosis. J Assoc Physicians India. 2003;51:257-60.
    [Google Scholar]
  3. , , , , , , . Clinical spectrum of paradoxical deterioration during antituberculosis therapy in non-HIV-infected patients. Eur J Clin Microbiol Infect Dis. 2002;21:803-9.
    [Google Scholar]
  4. , . Cerebral tuberculoma as a manifestation of paradoxical reaction in patients with pulmonary and extra - pulmonary tuberculosis: Case reports and review of literature. J Neurosc Rural Pract. 2012;3:350-4.
    [Google Scholar]
  5. , , , , . Complications of antiretroviral therapy in patients with tuberculosis: Drug interactions, toxicity, and immune reconstitution inflammatory syndrome. J Infect Dis. 2007;196(Suppl 1):S63-75.
    [Google Scholar]

    Fulltext Views
    311

    PDF downloads
    224
    View/Download PDF
    Download Citations
    BibTeX
    RIS
    Show Sections