The treatment of tuberculous tracheobronchitis with streptomycin.

Tuberculous tracheobronchitis is a frequent and important complication or concomitant finding in pulmonary tuberculosis. The stage, extent and course of the pathological bronchial changes usually determine the type of therapeutic procedures to be used for the control of the pulmonary tuberculosis. Treatment of tuberculous tracheobronchitis was unsatisfactory prior to the use of streptomycin. The prevention of chronic bronchial changes, such as tuberculous bronchiectasis and fibrostenosis, will solve many of the therapeutic problems of pulmonary tuberculosis. Successful control of the serious effects of tuberculous tracheobronchitis is essential to obtain satisfactory end results in the treatment of pulmonary tuberculosis. Early reports by Brewer and Bogen,’ and O’Keefe2 indicated that ulcerogranulomatous lesions of the trachea and major bronchi responded well to combined intramuscular and inhalation treatment with streptomycin. Subsequently, inhalation therapy with streptomycmn was found to be irritating and generally its use has been discarded. Pfuetze and Pyle3 state, “Almost without exception, ulcerating and granulomatous lesions of the oropharynx, larynx and tracheobronchial tree have healed within a few weeks when streptomycin was administered.” Tucker4 reports, “The effect of streptomycin on tuberculous lesions of the mucosa of the larynx and tracheobronchial tree is striking.” The excellent cooperative study by the Veterans Administration, Army and Navy5 on the effects of streptomycin in the treatment of tuberculosis proves rather conclusively that this drug, in varying doses and regimens, is capable of producing improvement in tuberculous tracheobronchitis and tuberculous laryngitis in 80 to 90 per cent of the cases selected for treatment.