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Year : 2019  |  Volume : 37  |  Issue : 3  |  Page : 450-453

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

Department of Internal Medicine, Batra Hospital and Medical Research Centre, New Delhi, India

Correspondence Address:
Dr. Thrinadh Kunapareddy
Department of Internal Medicine, Batra Hospital, New Delhi - 110 062
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijmm.IJMM_18_242

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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.


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2004 - Indian Journal of Medical Microbiology
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