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Pulmonary tuberculosis presents a varied picture. Some cases are continuously afebrile, others run a low-grade temperature without an afternoon rise above 99.6 for months, others run a low-grade temperature as a rule, but are subject to acute exacerbations, while others run a continuously high fever of the intermittent type and progress rapidly to a fatal termination.
We are in the habit of looking on the afebrile cases with low-grade fever as the most favorable and the cases showing acute exacerbations as unstable, uncertain and unfavorable. In general this assumption is correct, and is borne out by clinical observation, but there is a certain group of these cases in the acute exacerbation class that are not unfavorable, and the acute exacerbation seems to have a profound influence on the tuberculous process. These cases are those showing an intercurrent or superimposed pneumonic infection of a rather severe character during the course of the
PETTIT JW. THE EFFECT OF INTERCURRENT PNEUMONIC COMPLICATIONS ON THE COURSE OF CHRONIC PULMONARY TUBERCULOSIS. JAMA. 1912;LVIII(12):852–854. doi:10.1001/jama.1912.04260030250011
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