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
