Paradoxical response to antituberculous therapy

ABSTRACT

A paradoxical response in a patient infected with tuberculosis is generally defined as the clinical or radiological worsening of pre-existing tuberculous lesions or the development of new lesions in a patient who initially improves with anti-tuberculosis therapy. It occurs in about 5% of patients with a clinical diagnosis of Mycobacterium tuberculosis infection. Since a rapid and accurate diagnostic test is lacking, the diagnosis of this paradoxical phenomenon can only be ascertained when other differential diagnoses such as secondary infections, inadequate anti-tuberculosis therapy as a result of drug resistance, poor compliance, and adverse reactions due to therapy are excluded