[Paradoxical reaction following antituberculosis therapy in immunocompetent patient]

Abstract

Introduction: The features of paradoxical reactions (PR) that occurred in non-HIV infected patients are rare and not well known.

Case report: The authors reported the case of a 21years old, non-immunocompromised, and HIV negative patient treated for disseminated tuberculosis. PR occurred after 8months after initiation of antituberculous treatment. PR presented as left cervical lymphadenopathy, pulmonary, pleural, costal and spinal location of the tuberculosis. The antituberculous drugs were prolonged. Patient's clinical symptoms improved initially. However, left inguinal lymphadenopathy appeared after 20months of antituberculous therapy. Inguinal lymph node biopsy revealed tuberculous lymphadenitis. The patient has a good compliance to the treatment. The patient was continued on same antituberculous treatment for a total of 28months. The cervical and inguinal lymphadenopathy disappeared and CT scan showed regression of thoracic, abdominal, costal and spinal lesions.

Conclusion: PR during antituberculous treatment must be considered after exclusion of other causes. No consensus on the therapeutic management of this entity has been developed to date.

Keywords: Adénopathie paradoxale; Antituberculeux; Antituberculous treatment; Management; Paradoxical lymphadenopathy; Paradoxical reaction; Prise en charge; Réaction paradoxale; Tuberculose; Tuberculosis.