title: Paradoxical reaction to antitubercular treatment in a case of pulmonary tuberculosis.
abstract: A 51-year-old man presented with intermittent fever, mild cough and loss of appetite of 1-month duration. His sputum smear was positive for acid-fast bacilli and his chest radiograph revealed apical infiltrations. The patient was treated with antitubercular therapy (ATT), recovered and was well for 1 month, after which he suddenly developed focal seizures. MRI of the brain with gadolinium enhancement showed high intensity nodular foci in the frontal, parietal and occipital regions. The patient was diagnosed as a case of paradoxical reaction to ATT, and was successfully managed with continued ATT and adjunctive steroid therapy.
authors.affiliation: Department of Internal Medicine, Patan Academy of Health Sciences, Kathmandu, Nepal.
authors.forename: Buddhi
authors.initials: B
authors.lastname: Paudyal
authors.affiliation: Amppipal Hospital, Gorkha, Nepal.
authors.forename: Kshitiz
authors.initials: K
authors.lastname: Paudel
authors.affiliation: Oxford University Clinical Research Unit, Patan Hospital, Kathmandu, Nepal.
authors.forename: Mila
authors.initials: M
authors.lastname: Shakya
authors.affiliation: Oxford University Clinical Research Unit, Patan Hospital, Kathmandu, Nepal.
authors.forename: Buddha
authors.initials: B
authors.lastname: Basnyat
mesh_terms: D000995:Antitubercular Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001921:Brain / Q000000981:diagnostic imaging*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D013902:Radiography, Thoracic; D012640:Seizures / Q000209:etiology; D020306:Tuberculosis, Central Nervous System / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy; D014397:Tuberculosis, Pulmonary / Q000000981:diagnostic imaging / Q000188:drug therapy*
chemical_list: D000995:Antitubercular Agents