ステロイド減量失敗により再燃, 死亡した急性結核性肺炎, 粟粒結核症の1例 AN AUTOPSY CASE OF ACUTE TUBERCULOUS PNEUMONIA AND MILIARY TUBERCULOSIS DETERIOLATED BY RAPID TAPERING OF CORTICOSTEROID
An autopsy case of acute tuberculous pneumonia and miliary tuberculosis in a 79-year-old man, was reported.<BR>He was admitted to the hospital because of high fever and dyspnea. Chest X-ray films showed diffuse confluent air-space opacities throughout both lung fields with small nodular and ground-glass lesions.<BR>Transbronchial lung biopsy of the right lower lobe was performed eight days after admission. The biopsy specimen was caseous granuloma with infiltrations of epithelioid cells and giant cells. Therefore, intensive anti-tuberculous chemotherapy with INH, RFP and SM, and tapering of predonisolone was started. Rapid tapering of corticosteroid gave rise to flare up of acute tuber culous pneumonia, and resulted in respiratory failure. The findings at autopsy were widely disseminated miliary tuberculosis, acute tuberculous pneumonia, interstitial pneumonitis, and multiple gastric ulcers.<BR>The use of corticosteroid in tuberculosis was discussed.
結核 54(6), 351-355, 1979