[Tuberculosis sequelae: clinical aspects]

Abstract

We studied the pulmonary diseases which had developed as consequent deformities after healing of tuberculosis, which we called tuberculosis sequelae. Results are described as follows. 1. The frequency of tuberculosis sequelae was about 6% in the patients with pulmonary diseases admitted to our hospital. 2. 93 cases of them consisted of 4 groups, which were 39 of repeated bacterial infection of lower respiratory tract, 23 of pulmonary aspergilloma, 13 of atypical mycobacteriosis and 28 of chronic respiratory failure. 3. Patients with tuberculosis sequelae were distributed more in the younger age group than others with resembled pulmonary diseases. The men to women ratio was about 2:1. Patients with pulmonary aspergilloma were younger than those with atypical mycobacteriosis. 4. Death rate in tuberculosis sequelae was about 5% per year. 46% of patients with atypical mycobacteriosis and 44% with chronic respiratory failure died within 4 years. 5. In chest X-ray findings, fibrosis and shrinkage of the lung, compensatory pulmonary emphysema, deformity or dilatation of bronchi, bulla formation and residual tuberculous cavities were recognized in 40 to 65% of the cases. Severe pleural thickness or past thoracoplasty were frequently recognized in the patients with chronic respiratory failure. All the patients with pulmonary aspergilloma had one or more residual cavities. 6. The frequency of systemic complications was not more than in the control population matched by age. Comparatively, serum IgG and IgA were elevated and PHA-induced lymphocyte activation was not lowered in the patients with pulmonary aspergilloma and atypical mycobacteriosis. From these results, the main factor in the development of tuberculosis sequelae seemed to be local defects of the chest.