James R. Johnson, MD
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Johnson JR. Special Problems in Treating Tuberculosis. Ann Intern Med. 1994;120:440-441. doi: 10.7326/0003-4819-120-5-199403010-00027
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Published: Ann Intern Med. 1994;120(5):440-441.
TO THE EDITOR:
In the study by Strang and colleagues , cited by Barnes and Barrows in their excellent review , it is true that the lower frequency of death due to tuberculous pericarditis among patients treated with prednisolone did not differ significantly from that in the control group (2 of 53 patients [4%] compared with 7 of 61 patients [11%]). However, in a subsequent larger study by Strang and associates , a lower pericarditis death rate was noted among patients who received prednisolone (2 of 76 patients [3%] compared with 10 of 74 patients [14%]) (P < 0.05). Taken together, these two randomized trials strongly suggest that corticosteroid therapy prevents death and hastens resolution of signs and symptoms in patients with tuberculous pericarditis. We favor liberal use in this setting, rather than only “in severely ill patients” .
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