The Use of Trypsin in the Therapy of Tuberculous Lymphadenitis and Tuberculous Fistulae

¹ Head of Department, Malben's Tuberculosis Hospital.

1. Seven cases of tuberculous lymphadenitis and two cases of bone tuberculosis (sternum and first rib) with tuberculous fistulae were treated.

2. All had previous antibiotic treatment without success for periods varying from four months to four years.

3. Treatment with trypsin given simultaneously with antibiotics effected a clinical cure within a period varying from three to six weeks.

4. Clinical healing was evidenced by a marked decrease in size of nodes, disappearance of nodes, closure of fistulae and scar formation. This does not imply cure from the histo-pathological point of view.

5. Bone tuberculosis healed more rapidly.

6. From a histo-pathological point of view all the biopsies performed at intervals and at the end of treatment showed either marked improvement of the histological picture or evidence of complete healing. The rich deposition of collagen in healed lesions is noteworthy. The material of the biopsied nodes at the end of treatment was negative on smear, culture and guinea pig inoculation for Koch's bacillus.

7. The schedule of treatment advised is as follows: Trypsin 5 mg. daily in two divided doses for six weeks, simultaneously with uninterrupted antibiotics, Rimifon and PAS daily for six months. An additional course of trypsin of three weeks' duration at the termination of the six months' period. No side effect was noted during treatment.

8.Trypsin administered together with antibiotics appears to be the treatment of choice of tuberculous lymphadenitis and tuberculous sinuses, secondary to the above, or bone tuberculosis.