Tuberculous adenitis

From IDWiki

Clinical Manifestations

Paradoxical Reactions

  • Paradoxial reaction including paradoxical upgrading reaction
  • Presents with enlarging lymphadenopathy during or sometimes after treatment
  • Occurs in 25% of adenitis
  • Likely represents a reaction to an antigenic stimulus in poorly-cleared disease
  • In post-treatment paradoxical reactions, need to differentiate from relapse
  • About half will be PCR positive, 20% will be AFB positive, but none are culture positive
  • 90% resolve spontaneously
  • Steroids used commonly