Paradoxical deterioration during the course of antituberculous treatment.

Paradoxical deterioration during antituberculous therapy is defined as the clinical or radiological worsening of pre-existing tuberculous lesions or the development of new lesions in a patient who initially improves. Although it has frequently been reported for patients infected with human immunodeficiency virus (HIV), it can also be seen in HIV-negative patients. Here, we present a case of miliary tuberculosis in a patient who clinically deteriorates after antituberculous treatment, and discuss this confusing entity under the light of the pertinent literature.