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Paradoxical reaction (PR) in tuberculous lymphadenitis among HIV-negative patients: retrospective cohort study
  1. Akhil Rajendra1,
  2. Kirti Sabnis2,
  3. Vishalakshi Jeyaseelan3,
  4. Priscilla Rupali2
  1. 1Department of General Medicine, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
  2. 2Department of Infectious Diseases, Christian Medical College, Vellore, Tamil Nadu, India
  3. 3Department of Biostatistics, Christian Medical College, Vellore, Tamil Nadu, India
  1. Correspondence to Dr Akhil Rajendra, Department of General Medicine, Christian Medical College and Hospital, Vellore 632004, Tamil Nadu, India; akhilrk1989{at}

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Dear Sir,

Paradoxical worsening in tuberculosis is an exuberant inflammatory reaction characterised by clinical or radiological worsening after initiation of antitubercular therapy in the absence of disease relapse or presence of another diagnosis.1 With no defined diagnostic criteria, this entity is diagnosed purely clinically after ruling out drug resistance, poor drug compliance and disease relapse. Described prevalence is varied across literature ranging from 2.3% to 23%.2 ,3 We here did a retrospective chart review of patients with tuberculous lymphadenitis to determine the incidence of this phenomenon and also to determine the clinical and laboratory risk factors for the same. Description of this entity in Indian literature has been scarce and …

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  • Contributors AR and KS collected the data, AR and VJ analysed the data. AR and PR drafted and revised the manuscript. KS and PR critically reviewed and approved the final version of the manuscript.

  • Competing interests None declared.

  • Ethics approval Institutional review board.

  • Provenance and peer review Not commissioned; internally peer reviewed.

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