Article · Volume 12, Issue 3 · pp. 140–143
Paradoxical Reaction in Lymph Node Tuberculosis Presented as Shoulder Osteomyelitis
V. P. Lakshmi1, B. Abhinandh1, Akhilesh Kunoor2, Thadi Mohan2, Aadharsa Sugunan3, Jerry Jose4
- 1Department of Pharmacy Practice, Amrita School of Pharmacy, Amrita Vishwa Vidyapeetham, Kochi, India.
- 2Departments of Respiratory Medicine and Orthopedics, Amrita School of Medicine, Amrita Vishwa Vidyapeetham, Kochi, India.
- 3Lecturer, Department of Pharmacy Practice, Amrita School of Pharmacy, Amrita Vishwa Vidyapeetham, India.
- 4Department of Pulmonology, Little Flower Hospital and Research Centre, Angamaly, Kerala, India.
Abstract
Paradoxical reactions (PRs) can be viewed as an abnormal immune response toward the anti-tubercular treatment (ATT). It is characterized by clinical worsening of the patient’s symptoms and signs following an initial improvement despite definitive treatment with ATT. Tubercular lymphadenitis is the most common extrapulmonary manifestation seen under PR. Other sites of involvement include the pleura, central nervous system, bones, and muscle. Although some paradoxical events may not require any intervention, studies have shown to have good outcomes using glucocorticoid therapy. This case reports a PR that involves tubercular lymphadenitis and osteomyelitis, which showed marked improvement of patient ailment following a 1-month course of oral steroid.
Keywords: Osteomyelitis; paradoxical reactions; prednisolone; tubercular lymphadenitis
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