DEFINITION
New lung lesions that develop during medication for tuberculosis which should be considered a transient worsening that ultimately improves with continuation of medication
IMAGING
– This condition occurs in 2 to 12 weeks of treatment
– Peripheral lung nodule or mass (1~8cm) ipsilateral to pleural effusion
– Heterogenous enhancing nodule/mass, no air-bronchogram or no tree-in-bud, abut pleura
PATHOLOGY
Immunologic rebound, more common in younger patient
TREATMENT
Firstly consider other cause which could aggravates the condition such as…
; drug compliance, drug fever, secondary infection, NTM infection, MDR-TBc … etc
If not, continuate medication, this condition is considered as self-limited
![Paradoxical response in tuberculosis](https://q-radiology.com/wp-content/uploads/2022/12/image-137-1024x681.png)