Neurological paradox during treatment in a non-HIV patient with pulmonary tuberculosis: A case report

• Published in: Asian Pacific Journal of Tropical Medicine
• Main Authors: Thanyalak Amornpojnimman, Song Srisilpa, Pornchai Sathirapanya
• Format: Article in Journal/Newspaper
• Language: English
• Published: Wolters Kluwer Medknow Publications 2022
• Subjects: mycobacterium tuberculosis; paradoxical reaction; nervous system; hiv; Arctic medicine. Tropical medicine; RC955-962; Arctic
• Online Access: https://doi.org/10.4103/1995-7645.356995; https://doaj.org/article/2935265d057441cc99064e09348e99ca

Rationale: To report neurological paradox in a non-HIV patient with pulmonary tuberculosis. Patient concerns: A 26-year-old non-human immunodeficiency virus immunosuppressed female patient presented with diffused headache, diplopia, ascending paraparesis with loss of bowel and bladder control. Diagnosis: Disseminated neurological paradoxical reaction developed during tuberculosis treatment in a non-human immunodeficiency virus patient. Intervention: High-dose intravenous corticosteroid was added to the anti-tuberculous drugs, followed by tapered dose of oral prednisolone in 3 months. Outcome: A favorable neurological outcome was obtained 6 months later. Lessons: Neurological paradoxical reaction cannot be overlooked among the tuberculosis-treated cases who present with newly emerged neurological disorders.