Resumo

RUIZ DEL OLMO IZUZQUIZA, Ignacio et al. Paradoxical reaction to antituberculosis treatment in an immunocompetent girl with pulmonary tuberculosis. Arch. argent. pediatr. [online]. 2017, vol.115, n.2, pp.e112-e115. ISSN 0325-0075.  http://dx.doi.org/10.5546/aap.2017.e112.

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.

Palavras-chave : Tuberculosis; Paradoxical reaction; Immunocompetence; Lymphadenitis; Steroids.

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