Intestinal Perforation as a Paradoxical Reaction to Tuberculosis

Paradoxical reactions (PR) to tuberculosis (TB) treatments are characterized by an initial improvement of the clinical symptoms followed by a clinical or radiological deterioration of existing TB lesions or by the development of new lesions. PR in the gastrointestinal system is a rare phenomenon. Moreover, intestinal perforation is an uncommon but potentially fatal complication of intestinal TB. We report the case of a 29-year-old female who presented with fever and abdominal pain that was associated with watery diarrhea. She was diagnosed as a case of intestinal TB. During her stay, she developed intestinal perforation following the initiation of anti-TB treatment. She was eventually managed as a case of intestinal perforation as a PR to TB.