Tuberculous adenitis

Clinical Manifestations

Paradoxical Reactions

• Paradoxial reaction including paradoxical upgrading reaction
• Occurs in 25% of adenitis
  • Usually during treatment but can occur after treatment
• Likely reaction to 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