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Cited by 87Tuberculosis Research and EpidemiologyDiagnosis and treatment of tuberculosisInfectious Diseases and Tuberculosis

Paradoxical responses in non-HIV-infected patients with peripheral lymph node tuberculosis

Cho, Oh-Hyun, Park, Ki-Ho, Kim, Tark, Song, Eun Hee, Jang, Eun-Young, Lee, Eun Jung, Chong, Yong Pil, Choi, Sang-Ho +4 more·2009·Journal of Infection
DOI 10.1016/j.jinf.2009.05.006
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Abstract

Objectives We evaluated the clinical characteristics and risk factors for the paradoxical response (PR) in non-HIV-infected patients with peripheral lymph node tuberculosis (TB). Methods Medical records of non-HIV-infected patients aged > or =16 years with peripheral lymph node TB treated in a tertiary hospital between January 1997 and August 2007 were analysed. PR was defined as clinical or radiological worsening of pre-existing TB lesions, or development of new lesions in a patient who had received anti-TB therapy for at least 2 weeks. Results Three hundred patients with lymph node TB were included. Of these, 235 patients (78%) had confirmed TB; the remaining 65 (22%) had probable TB and were excluded from the final analysis. Among the 235 study patients, their mean age (+/-standard deviation) was 37.6 (+/-13.9) years and 175 (75%) were female. PR occurred in 54 (23%; 95% confidence interval 18-28%) patients, at a median onset time of 8 weeks (interquartile range, 4-14 weeks) after starting anti-TB medication. In multivariate analysis, younger age (OR 0.96), male gender (OR 2.60), and the presence of local tenderness at the time of diagnosis (OR 2.90) were independently associated with PR. Conclusion PR was relatively common, occurring in one-fifth of non-HIV-infected patients with peripheral lymph node TB, and was associated with younger age, male gender, and the presence of local tenderness.

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  • PUR is independently associated with male sex (OR 2.60) and local tenderness at diagnosis (OR 2.90).

    “Male sex (OR, 2.60) and the presence of local tenderness at the time of diagnosis (OR, 2.90) were independently associated with PUR [49].”

    From Current diagnosis and management of peripheral tuberculous lymphadenitis. (2011) · cites this paper as [49]

  • PUR manifestations have included node enlargement in 32%-68%, new nodes in 27%-36%, pain in 60%, and draining sinuses in 12%-60%.

    “Manifestations of PUR have included enlarging lymph nodes in 32%-68% of cases [50], new nodes in 27%-36%, pain in 60%, and draining sinuses in 12%60% [5, 49, 50].”

    From Current diagnosis and management of peripheral tuberculous lymphadenitis. (2011) · cites this paper as [49]

  • Reports from California and South Korea described PUR onset at a mean of 2-3.5 months after treatment began, resolving after a mean of 3.9 further months.

    “In reports from California and South Korea, onset occurred at a mean of 2-3.5 months after initiation of treatment and resolved at a mean of 3.9 additional months [5, 49].”

    From Current diagnosis and management of peripheral tuberculous lymphadenitis. (2011) · cites this paper as [49]

  • Among HIV-negative patients, PUR has been reported in 20%-23%.

    “PURhas been reported in 20%-23% of HIV-negative patients [5, 49, 50].”

    From Current diagnosis and management of peripheral tuberculous lymphadenitis. (2011) · cites this paper as [49]

  • For adults with peripheral lymphadenitis, treatment outcome data come only from uncontrolled studies.

    “Only uncontrolled studies are available on treatment outcomes in adults with peripheral lymphadenitis [49, 50].”

    From Current diagnosis and management of peripheral tuberculous lymphadenitis. (2011) · cites this paper as [49]

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Authors
Cho, O.-H., Park, K.-H., Kim, T., Song, E. H., Jang, E.-Y., Lee, E. J., Chong, Y. P., Choi, S.-H., Lee, S.-O., Woo, J. H., Kim, Y. S., & Kim, S.-H.
Affiliations
Asan Medical Center (KR)
Corresponding author
Kim, Sung-Han
ORCID
Venue
Journal of Infection
Publisher
Elsevier BV
Published
2009-07
Volume
59
Issue
1
Pages
56-61
ISSN
0163-4453 (ISSN-L)
DOI
10.1016/j.jinf.2009.05.006
OpenAlex
W2131128928
Cited by
87
References
22
Citations by year
2026: 5 · 2025: 5 · 2023: 7 · 2022: 8 · 2021: 2 · 2020: 6 · 2019: 4 · 2018: 7 · 2017: 4 · 2016: 8 · 2015: 6 · 2014: 5 · 2013: 6 · 2012: 5
FWCI
3.20
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Journal of Infection (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Infectious Diseases › Tuberculosis Research and Epidemiology
  • Health Sciences › Medicine › Surgery › Diagnosis and treatment of tuberculosis
  • Health Sciences › Medicine › Surgery › Infectious Diseases and Tuberculosis
Keywords
paradoxical reaction, peripheral lymph node tuberculosis, non-HIV-infected patients, risk factors, tuberculosis treatment, age and sex differences
MeSH terms
Adult, Antitubercular Agents, Female, Humans, Male, Middle Aged, Mycobacterium tuberculosis, Tuberculosis, Lymph Node, HIV Infections, Young Adult

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