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April 1964

Rapid Clearing in Hematogenous Pulmonary Tuberculosis

Author Affiliations


From the Pulmonary Disease Service, Veterans Administration Hospital, and the Department of Medicine, Georgetown University School of Medicine.

Arch Intern Med. 1964;113(4):573-577. doi:10.1001/archinte.1964.00280100081013

Introduction  At best, marked radiographic clearing in pulmonary tuberculosis, even with the most potent antibiotics available, is usually measured in months. The combination of corticosteroids with antituberculosis drugs hastens roentgen clearing especially at the onset of treatment. However, in nonhematogenous pulmonary tuberculosis, even with this combination therapy, several weeks are required before significant roentgen clearing is seen. On the other hand, scattered reports 1,2 are available indicating more rapid clearing in hematogenous pulmonary tuberculosis when steroids and antimicrobial agents are combined. It is the purpose of this paper to report three cases of hematogenous pulmonary tuberculosis which exhibited marked-to-complete clearing within 14 days on combined therapy. Furthermore, these cases illustrate that the diagnosis of hematogenous pulmonary tuberculosis must not be discarded because of rapid clearing of a diffuse lesion if the patient is receiving steroids.

Report of Cases 

Case 1.  —This 47-year-old Negro male was admitted to the VA Hospital,

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