Corticotropin and corticosteroid therapy in tuberculosis.

Introduction Hope of benefit from the use of corticotropin and corticosteroid in various types of bacterial infections is based on three assumptions: first, that some reactions to infections may be themselves quite harmful to the host; second, that these hormones in some poorly understood way alter or suppress host responses to infection; third, that the available antimicrobial agents are capable of controlling the infection in a host which has been so altered. The costly aspects of some host reactions to tuberculous infection are well known. In acute wide-spread pulmonary tuberculosis the marked toxicity and at times impaired respiratory function may result in early fatality before the full effects of chemotherapy have developed. (Four cases thought to be in this category are the basis of this report.) In chronic stages replacement of parenchyma by fibrosis implies some permanent functional impairment. Caseation necrosis is locally bacteriostatic, 1 but it also may lead