Chest
Volume 71, Issue 4, April 1977, Pages 540-542
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Clinical Pulmonary Tuberculosis in an Asthmatic Patient using a Steroid Aerosol

https://doi.org/10.1378/chest.71.4.540Get rights and content

A patient who was receiving a steroid aerosol for treatment of asthma developed clinical pulmonary tuberculosis. Continued administration of the steroid aerosol along with antituberculosis chemotherapy did not adversely influence healing of the pulmonary lesion.

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CASE REPORT

A 43-year-old housewife was referred to National Jewish Hospital and Research Center (NJHRC) in July, 1974 for control of asthma of nine years' duration. Her symptoms were perennial and exacerbated by respiratory infections and irritant exposure. Since November, 1973 she had become steroid-dependent, receiving dexamethasone 0.6 to 1.5 mg daily. Isoniazid (INH) was also given for tuberculosis chemoprophylaxis, but was discontinued because of gastrointestinal distress. A tuberculin skin test was

DISCUSSION

The diagnosis of tuberculosis in this patient is supported by the following data: (1) the location and appearance of the roentgenographic infiltrate; (2) the strongly positive tuberculosis skin test; (3) the positive smear for acid-fast bacilli with typical morphology for M tuberculosis; (4) the inability to demonstrate another pathologic process causing the disease; and (5) the resolution of the roentgenographic infiltrate following antituberculosis chemotherapy.

Since the sputum samples were

ACKNOWLEDGMENTS

We thank Dr. A. David Russakoff for his generous help in preparing this report, and Drs. Paul T. Davidson and Thomas L. Petty for their helpful suggestions and critical review of the manuscript.

REFERENCES (12)

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Supported in part by Allergic Disease Center Grant No. AI-10398.

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