Paradoxical Lymphadenopathy after Successful Treatment of Tuberculous Pleuritis
Esfandiar Shojaei *
Department of Infectious Diseases, Tehran University of Medical Sciences, Keshaverz Blv., Imam Khomeini Hospital Complex, Tehran, Iran.
Mehrnaz Rasoolinejad
Department of Infectious Diseases, Tehran University of Medical Sciences, Keshaverz Blv., Imam Khomeini Hospital Complex, Tehran, Iran.
Saeed Kalantari
Department of Infectious Diseases, Iran University of Medical Sciences, Satarkhan Ave, Rasool-e- Akram Hospital, Tehran, Iran.
*Author to whom correspondence should be addressed.
Abstract
Tuberculous lymphadenopathy can paradoxically increase in size after initial clinical improvement. This paradoxical reaction during tuberculosis treatment is more common among HIV positive than non-HIV patients. However paradoxical reaction must not be primary diagnosis and it is crucial to be sure about patientsˋ good compliance in using antituberculosis medications as well as having sensitive mycobacterial strain. In addition other pathological problems (eg. neoplasia, other non tuberculous mycobacterial infections) should be excluded. We report a case of pleural tuberculosis, complicated by cervical lymphadenopathy near the end of her treatment.
Keywords: Pleural tuberculosis, paradoxical reaction, lymphadenopathy