RT Journal Article
T1 Paradoxical reaction in immunocompetent children with tuberculosis
A1 Carazo Gallego, Begona
A1 Moreno-Perez, David
A1 Nunez Cuadros, Esmeralda
A1 Mesa Fernandez, Alba
A1 Martin Cantero, Maria
A1 Obando Pacheco, Pablo
A1 Urda Cardona, Antonio
K1 Tuberculosis
K1 Paradoxical reaction
K1 Immunocompetent
K1 Corticosteroids
K1 Children
K1 Reconstitution inflammatory syndrome
K1 Clinical spectrum
K1 Case definitions
K1 Risk-factors
K1 Therapy
K1 Deterioration
AB Background: A paradoxical reaction (PR) during anti-tuberculosis treatment is a phenomenon that is poorly studied in immunocompetent children. It is defined as a clinical or radiological worsening of preexisting tuberculosis (TB) disease.Methods: A retrospective descriptive study of children younger than 14 years of age was performed; these children developed PR during the years 2009 to 2014, following a diagnosis of TB. Demographic characteristics, microbiological results, treatment and outcome data were collected.Results: Of 51 children diagnosed with TB, five (9.8%) developed a PR; four of these children had pulmonary TB and the remaining patient had miliary TB with central nervous system involvement. The PR occurred at a median of 42 days (range 23-53 days) after initiating therapy. Corticosteroids were started when PR was suspected, at a median dose of 1 mg/kg/day. Clinical and radiological improvement was noted in all cases, with a median clinical regression time of 10.5 days (range 3-15 days) and a median radiological regression time of 45 days (range 26-105 days). No sequelae were described in any patient.Conclusions: PR in immunocompetent children during anti-tuberculosis treatment is not such an unusual reaction. Treatment with corticosteroids may be useful for the resolution of PR. (C) 2016 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. This is an open access article under the CC BY-NC-ND license.
PB Elsevier sci ltd
SN 1201-9712
YR 2016
FD 2016-10-01
LK http://hdl.handle.net/10668/18797
UL http://hdl.handle.net/10668/18797
LA en
DS RISalud
RD Apr 9, 2025