Therapeutic use of infliximab in tuberculosis to control severe paradoxical reaction of the brain and lymph nodes.

Paradoxical reactions are immune-mediated exacerbations of disease triggered by tuberculosis treatment. Paradoxical reactions involving the central nervous system may be life threatening. Infliximab (tumor necrosis factor antibody) profoundly inhibits cellular immune responses to Mycobacterium tuberculosis. We describe a case in which infliximab was used to control steroid-resistant tuberculosis paradoxical reaction involving the central nervous system.