Development of contralateral pleural effusion during chemotherapy for tuberculous pleurisy

Paradoxical worsening of tuberculous lesions, despite effective chemotherap y, has been reported in intracranial tuberculomas, lymph nodes, pulmonary d isease, and tuberculous pleurisy. However, development of contralateral ple ural effusion during treatment of tuberculous pleurisy is very rare. We rep ort the case of a 22 year old female patient who presented with right sided pleural effusion and was treated with antituberculous drugs. Four weeks la ter although her right sided pleural effusion was subsiding she developed a left sided pleural effusion. Closed pleural biopsy on the left si;ie showe d granulomatous inflammation with early caseation. Antituberculous drugs we re continued and a short course of oral prednisolone was added. She recover ed completely and her chest x-ray became normal after finishing her treatme nt.