Paradoxical expansion of intracranial tuberculomas during chemotherapy.
A patient from India with military lung tuberculosis who developed intracranial tuberculomas under treatment with tuberculostatics is described. Computed tomography (CT) scans of the brain showed a progress of tuberculomas despite effective tuberculostatic therapy and adjunctive corticosteroid treatment. This phenomenon, termed 'paradoxical response' has rarely been reported. Continuation of chemotherapy led to improvement of brain lesions and a recovery of miliary tuberculosis. When intracranial tuberculomas develop, therapy should be continued for longer than is customary for uncomplicated tuberculosis infections. The use of steroids to suppress a 'paradoxical response' is not proven.
Reiser
M
M
Medizinische Klinik I, University of Cologne, Germany.
Fätkenheuer
G
G
Diehl
V
V
D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D000995:Antitubercular Agents / Q000627:therapeutic use*; D002540:Cerebral Cortex / Q000382:microbiology / Q000473:pathology; D005260:Female; D006801:Humans; D013256:Steroids; D014057:Tomography, X-Ray Computed; D016862:Tuberculoma, Intracranial / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology*; D014391:Tuberculosis, Miliary / Q000150:complications* / Q000188:drug therapy
D000893:Anti-Inflammatory Agents; D000995:Antitubercular Agents; D013256:Steroids