Paradoxical enlargement of intracranial tuberculomas during treatment of tuberculous meningitis: report of a case.

P Thajeb, S K Lie, J S Huang, T Y Chen, T R Chiang
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Abstract

We report a case of a 32-year-old man who showed paradoxical enlargement of pathologically verified intracranial tuberculomas during a course of adequate antituberculous chemotherapy. Serial computed tomographic scans of the brain disclosed this uncommon phenomenon. Total excision of the lesions with concomitant four-combined antituberculous therapy proved successful. Although the mechanism of this paradoxical phenomenon is not well understood, a defective local tissue immune response with gradually increasing maturity of the lesions during antituberculous therapy, which results in poor penetration of these drugs into the lesions, might be a possible explanation.

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结核性脑膜炎治疗中颅内结核瘤的反常增大:1例报告。
我们报告一个32岁的男性病例,他在适当的抗结核化疗过程中表现出病理证实的颅内结核瘤的矛盾扩大。大脑的连续计算机断层扫描揭示了这种不寻常的现象。病灶全切除并联合四种抗结核药物治疗是成功的。虽然这种矛盾现象的机制尚不清楚,但在抗结核治疗过程中,随着病变逐渐成熟,局部组织免疫反应出现缺陷,导致这些药物无法渗透到病变中,这可能是一种可能的解释。
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