title: Paradoxical reaction of tuberculous vertebral osteomyelitis: a case series.
abstract: Paradoxical reactions of tuberculosis (TB) in vertebral osteomyelitis are very rarely reported. We experienced four cases of severe paradoxical reactions in tuberculous vertebral osteomyelitis. Four cases of tuberculous vertebral osteomyelitis were confirmed by an acid-fast bacilli smear or culture. The patients were human immunodeficiency virus negative, and were all initially treated with isoniazid, ethambutol, rifampicin and pyrazinamide. Their symptoms improved with anti-TB drugs. However, after 2-12 weeks, their symptoms had recurred, and spinal magnetic resonance imaging at the time of readmission revealed an aggravation of vertebral osteomyelitis. Operations were carried out to relieve severe pain or spinal cord decompression. Through continued anti-TB drug therapy, all patients recovered without sequelae.
authors.affiliation: From the Department of Internal Medicine, Inha University School of Medicine , Incheon , Republic of Korea.
authors.forename: Jae Hyoung
authors.initials: JH
authors.lastname: Im
authors.forename: Ji Hyeon
authors.initials: JH
authors.lastname: Baek
authors.forename: Hea Yoon
authors.initials: HY
authors.lastname: Kwon
authors.forename: Jin Soo
authors.initials: JS
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010019:Osteomyelitis; D013122:Spinal Diseases; D013131:Spine / Q000473:pathology; D014394:Tuberculosis, Osteoarticular; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents
keywords: Mycobacterium tuberculosis; osteomyelitis; spinal; tuberculosis; vertebral column