Paradoxical enlargement of intracranial tuberculomas during treatment of tuberculous meningitis: report of a case.
We report a case of a 32-year-old man who showed paradoxical enlargement of pathologically verified intracranial tuberculomas during a course of adequate antituberculous chemotherapy. Serial computed tomographic scans of the brain disclosed this uncommon phenomenon. Total excision of the lesions with concomitant four-combined antituberculous therapy proved successful. Although the mechanism of this paradoxical phenomenon is not well understood, a defective local tissue immune response with gradually increasing maturity of the lesions during antituberculous therapy, which results in poor penetration of these drugs into the lesions, might be a possible explanation.
Thajeb
P
P
Lie
S K
SK
Huang
J S
JS
Chen
T Y
TY
Chiang
T R
TR
D000328:Adult; D000995:Antitubercular Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001927:Brain Diseases / Q000188:drug therapy / Q000473:pathology; D006801:Humans; D008297:Male; D014375:Tuberculoma / Q000188:drug therapy / Q000473:pathology; D014390:Tuberculosis, Meningeal / Q000188:drug therapy*
D000995:Antitubercular Agents