Tuberculosis. Captain of all these men of death

The intent of this review was to familiarize the reader with the fascinating history of TB. I quote from Robert Louis Stevenson: "It is not a hard thing to know what to write; the hard thing is to know what to leave out." Also, this review by its very nature must be incomplete. It is certain that TB was present before the beginning of recorded history; it also is certain that we have not yet seen the end of the white plague. In the United States, the number of reported cases of TB decreased from 84,304 in 1953 to 22,201 in 1985, an average annual decline of 5.8%. Unfortunately, however, the number of cases has been increasing since 1985. These cases are predominantly in racial/ethnic minorities, persons from 25 to 44 years of age, men, and immigrants. Human immunodeficiency virus infection is at least partly responsible for the increasing number of cases. Additionally, new strains of M. tuberculosis that are resistant to multiple antituberculous drugs are being seen more and more frequently. In the mid-twentieth century, it was widely believed that advances in antituberculous chemotherapy and radiographic diagnosis might result in eradication of TB; this hope has not been realized. It is obvious that new challenges exist, and that others may lie ahead. One hopes that further advances will be made that will enable us to control this greatest killer of mankind, "The Captain of All These Men of Death."