title: Paradoxical reaction to antitubercular therapy in miliary tuberculosis.
abstract: An 18-year-old boy presented with fever, weight loss and loss of appetite for 6 months duration. Investigation revealed raised erythrocyte sedimentation rate, negative sputum smear examination for acid-fast bacilli, x-ray and high-resolution CT chest showed bilateral, diffuse infiltration of lung parenchyma with miliary shadows. The patient was treated as a case of miliary tuberculosis with antitubercular therapy (ATT). On the 10th day of treatment the patient developed high-grade fever, cough and breathlessness. Chest x-ray showed an increased infiltration of lung parenchyma. The patient was diagnosed as a case of paradoxical reaction to ATT and was managed successfully with steroids.
authors.affiliation: Department of Medical Division, Military Hospital Jodhpur, Jodhpur, Rajasthan, India. drankushgupta@gmail.com
authors.forename: Ankush
authors.initials: A
authors.lastname: Gupta
authors.forename: Vijay Kumar
authors.initials: VK
authors.lastname: Srivastava
authors.forename: Vibhu Narain
authors.initials: VN
authors.lastname: Khanna
authors.forename: Imran
authors.initials: I
authors.lastname: Rizvi
mesh_terms: D000293:Adolescent; D000995:Antitubercular Agents / Q000009:adverse effects* / Q000627:therapeutic use; D003937:Diagnosis, Differential; D018450:Disease Progression; D004359:Drug Therapy, Combination; D006801:Humans; D008297:Male; D011856:Radiographic Image Enhancement / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods; D014391:Tuberculosis, Miliary / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy*; D014397:Tuberculosis, Pulmonary / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy*
chemical_list: D000995:Antitubercular Agents