[Paradoxical tuberculosis reaction]. / Réaction paradoxale tuberculeuse.
Rev Med Interne
; 45(5): 279-288, 2024 May.
Article
in Fr
| MEDLINE
| ID: mdl-38267320
ABSTRACT
Paradoxical tuberculosis reaction is defined as the aggravation of lesions present at diagnosis or the development of new lesions under anti-tuberculosis treatment, after exclusion of other alternate causes. It affects 5 to 30% of tuberculosis patients, with a variable prevalence depending on the site of infection and the clinical background. The diagnosis of paradoxical reaction is one of elimination, and requires having ruled out therapeutic failure, notably linked to poor compliance and/or to the presence of mycobacterial antibiotic resistance. The severity of paradoxical tuberculosis reaction lies in its neurological impairment. Despite its clinical importance, the mechanisms involved remain poorly understood and its management is not consensual. Corticosteroids are the cornerstone in the medical management. The role of anti-TNF agents, currently proposed in cases of corticodependence or corticoresistance, remains to be properly defined.
Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Tuberculosis
/
Antitubercular Agents
Type of study:
Risk_factors_studies
Limits:
Humans
Language:
Fr
Journal:
Rev Med Interne
Year:
2024
Document type:
Article