Anatomic-Pathologic Comparative Study of Pulmonary Tuberculosis Deaths With and Without Streptomycin

¹ The Hospital Del Salvador, Santiago, Chile.

We have examined from an anatomic-pathological viewpoint two groups of pulmonary tuberculosis deaths, chronologically continuous but different: 204 not treated with streptomycin and 55 treated with streptomycin. Both groups were comparable as regards age and sex. No appreciable differences as regards pleural complications and meningitis were found. The cavities in the treated group were larger, older, and showed more frequent perforations in the pleura. In the same group, that is those treated with streptomycin, new cavities were less frequent.

Among the group which received streptomycin there was an increase in the total time of evolution of the pulmonary tuberculosis.

Also in the group treated with streptomycin there was a marked lowering of the glandular, laryngeal, pulmonary and intestinal disseminations produced through the lymphatic and the hematic systems as well as of those produced through the lumen of the different tracts.

Another marked lessening found in the group treated with streptomycin was in the amount of fatty livers.

The acute reinfection pulmonary forms disappeared almost completely in the group treated with streptomycin.

The most marked effect of the drug is the lessening of extrathoracic dispersions and the tendency to transform exudative processes into productive processes. On the other hand, the cavity problem does not respond to streptomycin. We can almost say that it is aggravated by use of the drug. For this reason, the responsibility for selecting therapies in the presence of cavernous tuberculosis has grown more serious with the advent of the antibiotics. There now exist greater possibilities of a definite cure, but only if proper judgment is used in combining other therapies in support of streptomycin.