[Paradoxical reaction to antituberculosis treatment in an immunocompetent girl with pulmonary tuberculosis].
Paradoxical reaction to antituberculosis treatment is rare in paediatric population. We report a 9-year-old girl with high fever and productive cough for the last three weeks. Tuberculine test and Quantiferon were positive, erythrocyte sedimentation rate was 64 mm/h, culture and polymerase chain reaction for M. tuberculosis negative, and chest X ray showed a widened right mediastinum. Tuberculosis was diagnosed, therefore treatment with standard doses of rifampicin, isoniazid, pyrazinamide and ethambutol was started. Twenty-one days later she presented high fever with no other symptoms, worsening of radiological findings and normal blood tests, serologies and brain magnetic resonance imaging. The patient presented a paradoxical reaction and was given prednisone 1 mg/kg/day, fever disappeared in 24 hours. It is important to consider a paradoxical reaction when other causes of clinical and/or radiological worsening have been ruled out, to avoid unnecessary tests and treatment modifications.
Servicio de Pediatría, Hospital de Alcañiz, Alcañiz, Teruel, España. jiruizdelolmo@salud.aragon.es.
Ignacio
I
Ruiz Del Olmo Izuzquiza
Servicio de Pediatría, Hospital de Alcañiz, Alcañiz, Teruel, España.
Claudia
C
Orden Rueda
Servicio de Pediatría, Hospital de Alcañiz, Alcañiz, Teruel, España.
Laura
L
Ochoa Gómez
Servicio de Pediatría, Hospital de Alcañiz, Alcañiz, Teruel, España.
Nuria
N
Clavero Montañés
Servicio de Pediatría, Hospital de Alcañiz, Alcañiz, Teruel, España.
Enrique
E
Berdún Chéliz
Unidad de Infectología, Servicio de Pediatría, Hospital Infantil Universitario Miguel Servet, Zaragoza, España.
Carmelo
C
Guerrero Laleona
D000995:Antitubercular Agents / Q000009:adverse effects*; D002648:Child; D018450:Disease Progression; D005260:Female; D006801:Humans; D007121:Immunocompetence; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy*
D000995:Antitubercular Agents
immunocompetence; lymphadenitis; paradoxical reaction; steroids; tuberculosis