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  • Title: Paradoxical enlargement of intracranial tuberculomas during treatment of tuberculous meningitis: report of a case.
    Author: Thajeb P, Lie SK, Huang JS, Chen TY, Chiang TR.
    Journal: Taiwan Yi Xue Hui Za Zhi; 1989 Oct; 88(10):1067-70. PubMed ID: 2634730.
    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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