2016
DOI: 10.1186/s12879-016-1625-9
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Abstract: BackgroundAwareness about paradoxical reactions in tuberculous meningitis is crucial as a paradoxical reaction may lead to certain wrong conclusions (for example, an erroneous diagnosis, and a possibility of treatment failure, mycobacterial drug-resistance, drug toxicity, or presence of a malignancy). The present study was planned to evaluate the incidence and predictive factors of paradoxical reactions in light of clinical, cerebrospinal fluid, and neuroimaging characteristics.MethodsIn this prospective cohor… Show more

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Cited by 77 publications
(62 citation statements)
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“…36 Postinfectious inflammatory lumbar arachnoiditis can also be seen following cryptococcal meningitis secondary to a postinfectious inflammatory response syndrome. Paradoxical worsening of TBM is an immunemediated response that can present up to a year after effective treatment, with 4% of patients developing spinal arachnoiditis.…”
Section: Inflammatory Conditionsmentioning
confidence: 99%
“…36 Postinfectious inflammatory lumbar arachnoiditis can also be seen following cryptococcal meningitis secondary to a postinfectious inflammatory response syndrome. Paradoxical worsening of TBM is an immunemediated response that can present up to a year after effective treatment, with 4% of patients developing spinal arachnoiditis.…”
Section: Inflammatory Conditionsmentioning
confidence: 99%
“…Whereas corticosteroids would be sufficient to control the inflammatory response in most patients, rendering the process clinically silent, others would develop a more extreme clinical syndrome of PR/IRIS in which corticosteroids alone are insufficient. In fact, although adjunctive treatment with corticosteroids has been shown to reduce mortality in patients with CNS-TB, [ 25 ] PR/IRIS still occurs in 31.2% to 56.0% of non-HIV-infected [ 26 , 27 ] and in 47% HIV-infected patients. [ 28 ]…”
Section: Discussionmentioning
confidence: 99%
“…However, many of these patients are asymptomatic during these episodes and the frequency of detecting paradoxical tuberculoma development or enlargement increases substantially (from 29% to 65%) if surveillance brain imaging is performed during the first six months of TB treatment 35 . Paradoxical TB reactions are more common in HIV-infected patients, particularly in those who commence antiretroviral therapy (ART) after starting TB treatment, in which case it is referred to as paradoxical TB-immune reconstitution inflammatory syndrome (TB-IRIS) [48][49][50][51] . The influence of HIV on the frequency of paradoxical tuberculoma reactions (separate from the effect of ART) has rarely been reported.…”
Section: Paradoxical Reactionsmentioning
confidence: 99%