Superior vena cava syndrome during the treatment of pulmonary tuberculosisin an HIV-1 infected patient

Tuberculosis is nowadays an uncommon cause of superior vena cava syndrome ( SVCS). We report the case of an HIV-infected patient who presented with res piratory symptoms accompanied by cervical and mediastinal lymphadenopathy S putum examination showed acid-fast bacilli, and treatment was instituted wi th isoniazid, rifampicin, pyrazinamide and ethambutol. A few days later SVC S developed, presumably as a consequence of inflammatory lymphadenitis, Wit h corticosteroids, all symptoms disappeared. To our knowledge, no cases of SVCS provoked by this kind of paradoxical reaction have been described prev iously. (C) 2000 The British Infection Society.