Paradoxical upgradation response in non-HIV tuberculosis: Report of two cases

Meghana Nathani Kabra, Thrinadh KunapareddyIndian Journal of Medical Microbiology 2019 37(3):450-453 A paradoxical upgradation response in tuberculosis (TB) is defined as the worsening of a pre-existing tubercular lesion or the appearance of a new lesion in a patient whose clinical symptoms initially improved with anti-TB treatment. A paradoxical response is common in HIV patients in the form of immune reconstitution inflammatory syndrome. A similar kind of response can also be seen in immunocompetent patients. Here, we present two cases of non-HIV TB who initially improved with antitubercular therapy (ATT) but worsened thereafter. After excluding possibilities such as multidrug-resistant TB, treatment failure or a superadded infection, a paradoxical upgradation response was diagnosed. Both the cases improved after treatment with corticosteroids in addition to ATT.
Source: Indian Journal of Medical Microbiology - Category: Microbiology Authors: Source Type: research