THREE CASES OF TUBERCULOSIS CHILDREN WHO DEMONSTRATED PARADOXICAL WORSENING DURING DIFFERENT STAGE OF TREATMENT

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  • KONDO Shinya
    epartment of Pediatrics, Tokyo Metropolitan Health and Medical Treatment Cooperation Tama-Hokubu Medical Center Division of Respiratory Disease, Tokyo Metropolitan Children's Hospital
  • MIYAGAWA Tomoo
    Division of Respiratory Disease, Tokyo Metropolitan Children's Hospital

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Other Title
  • 発現時期の異なるｐａｒａｄｏｘｉｃａｌ　ｗｏｒｓｅｎｉｎｇを呈した３名の結核小児
  • ショウレイ ホウコク ハツゲン ジキ ノ コトナル paradoxical worsening オ テイシタ 3メイ ノ ケッカク ショウニ

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Abstract

We report three tuberculosis children aged sevenmonthold to II-year-old who had paradoxical worsening of tuberculosis of lung and lymph nodes, lymph nodes, and intracranial tuberculoma at different treatment stages. In these children, paradoxical worsening occurred at about 14 days after start of anti-tuberculosis treatment, about six months after the start, and about three months after the completion of treatment. No alteration was done in the method of anti-tube rculosis treatment against expanding lesions, and predonisolone was prescribed in two subjects. Expanded lesions then improved one- to five-months later. The mechanisms of paradoxical worsening is unclear. However, these cases suggest that paradoxical worsening may occur at any time after starting anti-tuberculosis treatment based on interaction between the microbial factors and host immunological factors in lung, lymph nodes, intracranial tuberculosis lesions.

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