Desai Lavina, Shah Ira, Shaan Manohar
Seth G. S. Medical College, KEM Hospital , Mumbai , India.
Department of Pediatric Infectious Diseases, Nanavati Hospital , Mumbai.
Paediatr Int Child Health. 2019 Nov;39(4):287-289. doi: 10.1080/20469047.2018.1518054. Epub 2018 Oct 4.
Paradoxical reactions (PRs) are exaggerated inflammatory responses owing to recovery of cellular immunity following initiation of anti-tuberculous therapy (ATT). The presentation is worsening of pre-existing symptoms or development of new lesions. A 14-year-old girl with multi-drug-resistant tuberculosis developed a recurrent asymptomatic retropharyngeal abscess while on ATT. She required multiple aspirations of the abscess. Xpert MTB/RIF detected from the aspirate which was resistant to rifampicin; culture was negative. Following aspirations of the abscess, continued ATT and a 2-month course of corticosteroids, she remains well and has gained weight. A retropharyngeal abscess presenting in the form of a PR has not been reported previously in adults or children.
矛盾反应（PRs）是抗结核治疗（ATT）开始后由于细胞免疫恢复而出现的过度炎症反应。表现为原有症状加重或出现新病灶。一名14岁的耐多药结核病女孩在接受ATT治疗期间出现复发性无症状咽后脓肿。她需要多次抽吸脓肿。Xpert MTB/RIF检测显示抽吸物对利福平耐药；培养结果为阴性。在脓肿抽吸、继续进行ATT治疗并使用2个月的皮质类固醇后，她情况良好且体重增加。此前未见有以PR形式出现的咽后脓肿在成人或儿童中的报道。
