Paradoxical Reaction In The Form Of New Pulmonary Mass During Anti-Tuberculosis Treatment: A Case Series And Literature Review

Infection and Drug Resistance

关键词: tuberculosis;    paradoxical reaction;    mass;   

DOI  :  

来源: DOAJ

【 摘 要 】

Ting Guo,1–3 Wei Guo,1–3 Min Song,1–3 Shanshan Ni,1–3 Man Luo,1–3 Ping Chen,1–3 Hong Peng1–3 1Department of Respiratory and Critical Care Medicine, The Second Xiangya Hospital of Central-South University, Changsha, Hunan 410011, People’s Republic of China; 2Research Unit of Respiratory Disease, Central-South University, Changsha, Hunan 410011, People’s Republic of China; 3The Respiratory Disease Diagnosis and Treatment Center of Hunan Province, Changsha, Hunan 410011, People’s Republic of ChinaCorrespondence: Hong PengDepartment of Respiratory and Critical Care Medicine, The Second Xiangya Hospital Of Central-South University, No. 139 Renmin Middle Road, Changsha, Hunan 410011, People’s Republic of ChinaTel [phone]Fax [phone]Email [e-mail]: Paradoxical reaction refers to deterioration of the original tuberculosis lesions or emergence of new infiltrative lesions during anti-tuberculosis treatment. The common manifestations of paradoxical reaction include new pleural effusion, cerebral tuberculosis and lymphadenitis. Paradoxical reaction manifested by new pulmonary mass is rare.Patients and methods: This article summarizes and analyzes the clinical manifestations, chest CT, laboratory findings, treatments, pathological biopsy results of five patients diagnosed as paradoxical reaction in the form of new pulmonary mass. A literature review related to paradoxical reaction was conducted.Results: Five patients diagnosed as pulmonary tuberculosis or tuberculous pleuritis received systematic anti-tuberculosis treatmensssts. New pulmonary masses were found by CT scans during the follow-ups. The patients were negative for tumor markers, examination of rheumatoid connective tissue disease and G/GM test. The original anti-tuberculosis treatments were continued. All of the masses were diminished gradually.Conclusion: Paradoxical reaction needs to be taken into consideration when a new pulmonary mass occurs during anti-tuberculosis treatments. The diagnosis should be based on the patients’ clinical manifestations, laboratory results, imaging examinsssations and lung biopsy examinations. The original anti-tuberculosis therapy can be continued in patients without severe clinical symptoms. A close follow-up is needed.Keywords: tuberculosis, paradoxical reaction, mass

【 授权许可】

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