Infliximab for Paradoxical Reactions in Pediatric Central Nervous System Tuberculosis

J Pediatric Infect Dis Soc. 2021 Dec 31;10(12):1087-1091. doi: 10.1093/jpids/piab094.


Paradoxical reactions in central nervous system tuberculosis (CNS-TB) are associated with significant morbidity and mortality. We describe 4 HIV-uninfected children treated for CNS-TB with severe paradoxical reactions unresponsive to corticosteroids. All made recovery after treatment with infliximab, highlighting the safety and effectiveness of infliximab for this complication, and need for prospective trials.

Keywords: central nervous system tuberculosis; infliximab; paradoxical reaction; tuberculous meningitis.

MeSH terms

  • Adrenal Cortex Hormones
  • Antitubercular Agents* / adverse effects
  • Child
  • Humans
  • Infliximab / adverse effects
  • Prospective Studies
  • Tuberculosis, Central Nervous System* / drug therapy


  • Adrenal Cortex Hormones
  • Antitubercular Agents
  • Infliximab