A radiographic progression during and after initial chemotherapy for pulmonary tuberculosis]

Transient radiographic progressions during or after antituberculous chemotherapy were observed in 60 (4.5%) out of 1,321 cases with active pulmonary tuberculosis who received an initial combination chemotherapy including INH and RFP. The radiographic patterns of these progressions were classified into a singular and a gregarious pattern. A correlation between the two radiographic patterns and a positive or negative culture in sputum at the time of the radiographic progressions was studied, revealing significantly more frequent singular patterns in culture negative cases while more frequent gregarious patterns in culture positive cases. In a majority of the cases, radiographic progressions developed within 3 months after an initiation of chemotherapy. Either of the increased shadows during chemotherapy or after completion of chemotherapy showed an improvement in a moderate degree or over and a good prognosis thereafter by continuous administration of the same drugs or under observation without retreatment respectively. It is concluded that radiographic progressions appeared during an intensive chemotherapy or after its completion do not always require changing the antituberculous drugs or resumption of chemotherapy.