Reiser M, Fätkenheuer G, Diehl V
Medizinische Klinik I, University of Cologne, Germany.
J Infect. 1997 Jul;35(1):88-90. doi: 10.1016/s0163-4453(97)91241-x.
A patient from India with military lung tuberculosis who developed intracranial tuberculomas under treatment with tuberculostatics is described. Computed tomography (CT) scans of the brain showed a progress of tuberculomas despite effective tuberculostatic therapy and adjunctive corticosteroid treatment. This phenomenon, termed 'paradoxical response' has rarely been reported. Continuation of chemotherapy led to improvement of brain lesions and a recovery of miliary tuberculosis. When intracranial tuberculomas develop, therapy should be continued for longer than is customary for uncomplicated tuberculosis infections. The use of steroids to suppress a 'paradoxical response' is not proven.
本文描述了一名来自印度的粟粒性肺结核患者，在接受抗结核药物治疗期间出现了颅内结核瘤。尽管进行了有效的抗结核治疗和辅助使用皮质类固醇治疗，但脑部计算机断层扫描（CT）显示结核瘤仍在进展。这种被称为“矛盾反应”的现象鲜有报道。继续化疗使脑部病变得到改善，粟粒性肺结核也得以康复。当出现颅内结核瘤时，治疗时间应比单纯肺结核感染的常规治疗时间更长。使用类固醇抑制“矛盾反应”的效果尚未得到证实。
