Unexplained Deterioration During Antituberculous Therapy in Children and Adolescents

Abstract

Deteriorations during therapy occur frequently among immunocompetent children and may present months into treatment as clinically significant events. Those with lower weight-for-age percentiles and with multiple sites of disease at initial presentation are more likely to deteriorate. Many patients improve with corticosteroids, supporting an immunopathologic basis for many of these episodes. These deteriorations can be difficult to distinguish from drug resistance, treatment failure, or infection with other pathogens.