[The 68th annual meeting symposium. III. Changes in the disease picture of pulmonary tuberculosis]

In the symposium on 'Changes in the disease picture of pulmonary tuberculosis', the themes mentioned above were discussed. Dr. Ohmori analyzed the present state of the epidemiology of tuberculosis in Japan. The stagnation in the decline of incidence rate of tuberculosis has been observed from the end of the 1970's. It is remarkable in the population aged 15-29 years. She noted two factors as the reason of such stagnation. Firstly, the number of tuberculosis cases increases in the high-aged subjects who were infected with tubercle bacilli in the past, as the population with high-age is expanding. Secondly, sporadic mass outbreak of tuberculosis is found often in the young subjects who have not been infected with tubercle bacilli. Dr. Miyazaki reported that 57 cases (8.5%) were classified as lower lung tuberculosis in 672 new cases with pulmonary tuberculosis during the last ten years. He noted the usefulness of fiberoptic bronchoscopy for diagnosis to lower lung field tuberculosis. Dr. Nagata analyzed the present state of mycobacterial disease in 5041 autopsy cases. The rate of cases with active mycobacteriosis was about 1% during the last 5 years. A large proportion of cases with fatal mycobacteriosis was received corticosteroid therapy. Antemortem diagnosis of mycobacteriosis was made in 25.9-20.0% of cases with fatal mycobacteriosis. Dr. Yamagishi showed the data of pulmonary tuberculosis in compromised hosts in a National Hospital. There were 82 cases associated with various type of cancer (4.2%) and 21 cases treated with corticosteroids (1.1%) among 1954 cases with pulmonary tuberculosis for the last 6 years.(ABSTRACT TRUNCATED AT 250 WORDS)