The infectious disease case. Paradoxal response on a VIH negative paient on treatment for tuberculosis

A 24 yo patient, HIV negative, presented with disseminated tuberculosis ( lung and CNS involvement).after a month of standard four drug regimen treatment, with goodl adherence and tolerance, patient clínical condition deteriorated with exacerbation of symptoms, mainly neurological. This syndrome is known as paradoxical response, usuatly seen recentiy in patients HIV positive, but was described several decades ago in HIV negative patients. Patient received treatment with steroids with an adequate clínical response and patient restarted his activities as a student.