Paradoxical Lymphadenopathy after Successful Treatment of Tuberculous Pleuritis

Tuberculous lymphadenopathy can paradoxically increase in size after initial clinical improvement. This paradoxical reaction during tuberculosis treatment is more common among HIV positive than non-HIV patients. However paradoxical reaction must not be primary diagnosis and it is crucial to be sure about patientsˋ good compliance in using antituberculosis medications as well as having sensitive mycobacterial strain. In addition other pathological problems (eg. neoplasia, other non tuberculous mycobacterial infections) should be excluded. We report a case of pleural tuberculosis, complicated by cervical lymphadenopathy near the end of her treatment.