Paradoxical reactions in the form of Optochiasmatic arachnoiditis and stroke in An immunocompetent girl with tuberculous Meningitis- a case report

Authors

  • Md Alamgir Hossain Registrar, Department of Neurology, Sir Salimullah Medical College Mitford Hospital, Dhaka- 1100, Bangladesh
  • Aminur Rahman Assistant Professor, Department of Neurology, Sir Salimullah Medical College, Dhaka- 1100, Bangladesh
  • Ajay Kumar Agarwalla Assistant Registrar, Department of Neurology, Sir Salimullah Medical College Mitford Hospital, Dhaka- 1100, Bangladesh
  • Muhammad Jamil Ahmed Registrar, Department of Neurology, Sylhet MAG Medical College Hospital, Sylhet, Bangladesh
  • Abul Hasnat Md Russel Resident, Department of Neurology, Sir Salimullah Medical College Mitford Hospital, Dhaka, Bangladesh
  • Shahjada Mohammad Dastegir Khan Assistant Professor, Department of Neurology, Sir Salimullah Medical College, Dhaka- 1100, Bangladesh
  • Mohammad Moshiur Rahman Assistant Professor, Department of Neurology, Sir Salimullah Medical College, Dhaka- 1100, Bangladesh
  • Biplab Paul Assistant Professor, Department of Neurology, Sir Salimullah Medical College, Dhaka- 1100, Bangladesh
  • Pallab Kanti Saha Assistant Professor, Department of Neurology, Sir Salimullah Medical College, Dhaka- 1100, Bangladesh
  • Zahed Ali Professor, Department of Neurology, Sir Salimullah Medical College, Dhaka- 1100, Bangladesh

DOI:

https://doi.org/10.3329/bjm.v34i3.68433

Keywords:

Paradoxical Reactions, Optochiasmatic Arachnoiditis, Immunocompetent, Tuberculous Meningitis

Abstract

The paradoxical response is characterized by clinical or radiologic worsening of pre-existing lesions or the appearance of new lesions following initiation of treatment for tuberculosis (TB). The paradoxical response has raised questions about the accuracy of the diagnosis, the potential for treatment failure, and the presence of an underlying disease, making it an important topic of care for clinicians. In this case report, we present the paradox reaction of a 14 year old girl diagnosed and treated for TB meningitis. This healthy immune girl is successfully treated with steroids, and we discuss the importance of treating the paradox of tuberculosis progression despite the use of effective anti-TB drugs.

Bangladesh J Medicine 2023; 34(3): 245-251

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Published

2023-09-03

How to Cite

Hossain, M. A., Rahman, A. ., Agarwalla, A. K., Ahmed, M. J., Md Russel, A. H., Dastegir Khan, S. M. ., Rahman, M. M., Paul, B., Saha, P. K. ., & Ali, Z. (2023). Paradoxical reactions in the form of Optochiasmatic arachnoiditis and stroke in An immunocompetent girl with tuberculous Meningitis- a case report. Bangladesh Journal of Medicine, 34(3), 245–251. https://doi.org/10.3329/bjm.v34i3.68433

Issue

Section

Case Reports