Editorial

Central Nervous System Tuberculosis and Paradoxical Response

Authors: Mohammad Wasay, MD, FRCP

Abstract

Tuberculosis (TB) is the 7th leading cause of death and disability worldwide and has reached epidemic proportions in both developed and undeveloped nations. Approximately 5 to 10% of tuberculosis cases involve the brain and central nervous system. Tuberculomas account for 10 to 30% of intracranial (IC) masses in TB-endemic areas. The clinical and neuroimaging features of tuberculoma are variable and may pose a diagnostic challenge in the absence of systemic TB or tuberculous meningitis.1

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References

1. Wasay M, Kheleani BA, Moolani MK, et al. Brain CT and MRI findings in 100 consecutive patients with intracranial tuberculoma. J Neuroimaging 2003;13:240–247.
 
2. Gupta M, Bajaj BK, Khawaja G. Paradoxical response in patients with CNS tuberculosis. J Assoc Physicians India 2003;51:257–260.
 
3. Breen RA, Smith CJ, Bettinson H, et al. Paradoxical reactions during tuberculosis treatment in patients with and without HIV co-infection. Thorax 2004;59:704–707.
 
4. Shelburne SA III, Hamill RJ. The immune reconstitution inflammatory syndrome. AIDS Rev2003;5:67–79.
 
5. Cheng VC, Yam WC, Woo PC, et al. Risk factors for development of paradoxical response during anti tuberculous therapy in HIV-negative patients. Eur J Clin Microbiol Infect Dis 2003;22:597–602.
 
6. Kalkan A, Serhatlioglu S, Ozden M, et al. Paradoxically developed optochiasmatic tuberculoma and tuberculous lymphadenitis: a case report with 18-month follow-up by MRI. South Med J 2006;99:388–392.
 
7. Rodriguez-Bano J, Muniain MA, Aznar J, et al. Systemic paradoxical response to anti tuberculous drugs: resolution with corticosteroid therapy. Clin Infect Dis 1997;24:517–519.