TRANSIENT EXACERBATION OF TUBERCULOUS LYMPHADENITIS DURING CHEMOTHERAPY IN PATIENTS WITH AIDS

We describe three men with disseminated, drug-sensitive tuberculosis a nd advanced human immunodeficiency virus disease (CD4+ lymphocyte coun t, <50/mm(3)) who had flares of tuberculous lymphadenitis with suppura tion during the initial weeks of successful chemotherapy. Bactericidal drugs may kindle these transient exacerbations, which involve neutrop hils but apparently do not require normal helper T cell function. In p atients with AIDS, as in immunocompetent individuals, treatment-relate d flares of lymphadenitis are usually not an adverse sign, provided th at drug resistance and nonadherence have been excluded.