Severe paradoxical reaction requiring tracheostomy in a human immunodeficiency virus (HIV)-negative patient with cervical lymph node tuberculosis

Yonsei Med J. 2008 Oct 31;49(5):853-6. doi: 10.3349/ymj.2008.49.5.853.


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.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

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