[Evaluation of aerosol therapy of streptomycin for tracheobronchial tuberculosis]

The clinical features of tracheobronchial tuberculosis are distinct from those of pulmonary tuberculosis in some aspects. Streptomycin (SM) is claimed by some investigators that it has a tendency to promote the development of bronchial stenosis. The purpose of the present investigation is to point out that aerosol therapy of SM is useful for patients with tracheobronchial tuberculosis. Prior to clinical application of the inhalation therapy, we confirmed that the therapy was not harmful. Serum concentration of SM, when inhaled, was measured in 9 volunteers. Before and after administration of SM aerosol, spirograms were examined in 4 volunteers, and no special abnormality was recognized. It seemed that serum concentration of SM after the administration was too low to evoke adverse reactions (less than 3.0 gamma). In 6 patients, blood gases were measured, and no obvious change was observed. In 41 patients with bronchial tuberculosis, bronchofiberscopic examinations were performed twice or more. We observed the ulcerous lesions of bronchial tuberculosis at various stages of healing, and could classify the ulcerous lesions into the following three stages. Active Stage: stage A; ulcer formation without regenerating epithelium, Healing Stage: stage H; ulcer formation with regenerating epithelium, Scarring Stage: stage S; and no ulcer formation. Only the lesions of stage A were observed before treatment. In many patients during the first and second month of treatment, the lesions were at stage A or H. It was found that healing of the lesions of tracheobronchial tuberculosis progressed through the stages A, H, and S, in this order.(ABSTRACT TRUNCATED AT 250 WORDS)