title: "Paradoxical" immune-mediated reactions to Mycobacterium ulcerans during antibiotic treatment: a result of treatment success, not failure.
abstract: We present the first clinical descriptions of immune-mediated paradoxical reactions to effective antibiotic treatment for Mycobacterium ulcerans infection, which result in clinical deterioration after initial improvement. Recognition of this phenomenon could prevent unnecessary changes to antibiotic regimens, and might obviate the need for, or reduce the extent of, further surgery.
authors.affiliation: Barwon Health, Geelong, VIC, Australia. daniel.obrien@amsterdam.msf.org
authors.forename: Daniel P
authors.initials: DP
authors.lastname: O'Brien
authors.forename: Michael E
authors.initials: ME
authors.lastname: Robson
authors.forename: Peter P
authors.initials: PP
authors.lastname: Callan
authors.forename: Anthony H
authors.initials: AH
authors.lastname: McDonald
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000942:Antigens, Bacterial / Q000276:immunology*; D054312:Buruli Ulcer / Q000188:drug therapy* / Q000473:pathology*; D006801:Humans; D054019:Immune Reconstitution Inflammatory Syndrome / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D019911:Mycobacterium ulcerans / Q000276:immunology*; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D000942:Antigens, Bacterial