[Three cases of tuberculosis children who demonstrated paradoxical worsening during different stage of treatment].
We report three tuberculosis children aged seven-month-old to 11-year-old who had paradoxical worsening of tuberculosis of lung and lymph nodes, lymph nodes, and intracranial tuberculoma at different treatment stages. In these children, paradoxical worsening occurred at about 14 days after start of anti-tuberculosis treatment, about six months after the start, and about three months after the completion of treatment. No alteration was done in the method of anti-tuberculosis treatment against expanding lesions, and predonisolone was prescribed in two subjects. Expanded lesions then improved one- to five-months later. The mechanisms of paradoxical worsening is unclear. However, these cases suggest that paradoxical worsening may occur at any time after starting anti-tuberculosis treatment based on interaction between the microbial factors and host immunological factors in lung, lymph nodes, intracranial tuberculosis lesions.
Kondo
Shinya
S
Department of Pediatrics, Tokyo Metropolitan Health and Medical Treatment Cooperation Tama-Hokubu Medical Center, 1-7-1, Aoba-cho, Higashimurayama-shi, Tokyo 189-8511 Japan. shinya_kondo@tamahoku-hp.jp
Miyagawa
Tomoo
T
D002648:Child; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D014376:Tuberculosis / Q000503:physiopathology*; D020306:Tuberculosis, Central Nervous System / Q000503:physiopathology; D014388:Tuberculosis, Lymph Node / Q000503:physiopathology; D014397:Tuberculosis, Pulmonary / Q000503:physiopathology