A Long-Term Followup of 30 Neuropsychiatric-Tuberculosis Patients with the "Open-Negative" Syndrome of Indefinitely Prolonged Chemotherapy

¹ Chief, Neuropsychiatric-Tuberculosis Service, VA Hospital.
² Consultant in Surgery and Tuberculosis, VA Hospital.

Thirty neuropsychiatric-tuberculous patients with "open negative" tuberculous cavities have been closely followed from two to over ten years. They have been treated by individualized combined chemotherapy from two to six years, depending on the extent of disease and patient's response to treatment. After two to five years of bacteriologic remission and x-ray film stability the patients received INH alone, 300 mg. daily. Four had single positive cultures after periods of up to 76 months of bacteriologic negativity with no x-ray shadow worsening.

Radiologic results reflecting changing morphology of lesions which followed prolonged sterilizing chemotherapy may explain the difficulties in interpretation of x-ray findings and discrepancies between roentgenograms and morphology found on pathologic examination.

The reported data form the basis for the writers' opinion that effective, prolonged chemotherapy seems indicated in patients with non-resected "open lesions" and that these patients, after 12 months of bacteriologic remission under chemotherapy, might be classified as probably inactive. INH, 300 mg. daily, given after 24 months of bacteriologic negativity has proved effective in preventing relapses.