Cho Young Bum, Chu Min Su, Ryu Han Seung, Choi Suck Chei, Seo Geom Seog
Department of Internal Medicine, Digestive Disease Research Institute, Wonkwang University School of Medicine, Iksan, Korea.
Korean J Gastroenterol. 2015 May;65(5):306-11. doi: 10.4166/kjg.2015.65.5.306.
Paradoxical reaction during antituberculosis therapy is defined as aggravation of preexisting tuberculous lesions or the development of new lesions. A 24-year-old female college student diagnosed with abdominal and pulmonary tuberculosis presented with fever and abdominal pain after having been treated with antituberculosis agents for 4 months. Tuberculous mesenteric lymphadenitis was suspected on abdominal CT scan and enlarged necrotic abscess was also present. These findings were considered to be due to paradoxical reaction rather than treatment failure during antituberculosis treatment. Although laparoscopic bowel adhesiolysis and abscess drainage were performed, high fever and severe abdominal pain did not improve. However, the patient eventually made a completely recovery after corticosteroid therapy combined with antituberculosis agents. Herein, we report a case of paradoxical reaction which developed in a patient with abdominal and pulmonary tuberculosis during antituberculosis therapy.
抗结核治疗期间的矛盾反应定义为原有结核病灶的加重或新病灶的出现。一名24岁被诊断为腹部和肺部结核的女大学生,在接受抗结核药物治疗4个月后出现发热和腹痛。腹部CT扫描怀疑为结核性肠系膜淋巴结炎,同时还存在肿大的坏死性脓肿。这些发现被认为是抗结核治疗期间的矛盾反应而非治疗失败所致。尽管进行了腹腔镜肠粘连松解术和脓肿引流,但高热和严重腹痛并未改善。然而,患者在糖皮质激素治疗联合抗结核药物后最终完全康复。在此,我们报告一例腹部和肺部结核患者在抗结核治疗期间发生矛盾反应的病例。