Characterization and Management of Paradoxical Upgrading Reactions in HIV-Uninfected Patients with Lymph Node Tuberculosis

Abstract
In a retrospective analysis, paradoxical deterioration of lymph node tuberculosis in human immunodeficiency virus-uninfected patients was common, occurring in 25 (23%) of 109 patients after treatment had been given for a median of 46 days (interquartile range, 21–139 days) and persisting for a median of 67.5 days (interquartile range, 34–111 days). We found no association between the use of steroids and the duration of reaction.