Use of Streptomycin in Gastrointestinal Tuberculosis

Abstract

Summary The use of streptomycin intramuscularly is characterized by rapid and usually complete relief of the symptoms of tuberculous enterocolitis and by varying degrees of improvement in the x-ray appearance of the bowel. Control of this serious complication, formerly of such ominous prognostic significance, can now be promised with almost as much assurance as applies to the use of penicillin in pneumonia. The duration of such improvement in the presence of uncontrolled pulmonary disease is unknown and some increment of recurrence may be anticipated. Despite dramatic relief of enteritis, a disappointingly small percentage of these patients are restored to health by the use of streptomycin alone. The type and extent of the associated pulmonary disease, its responsiveness to streptomycin and its suitability for compression therapy are major factors in the determination of the final, over-all result. Only two of our eighteen patients were restored to health by streptomycin alone and one of these had minimal pulmonary disease. The four additional patients discharged as arrested cases had some form of compression therapy (phreniclasia, pneumoperitoneum, pneumothorax or thoracoplasty) in addition to streptomycin. One patient died after thoracoplasty and the ultimate outlook of the eleven who remain is now, as it was before the development of enteritis, entirely dependent upon the status of their pulmonary lesions. In six cases the outlook is frankly hopeless but in the remaining five, the control of enterocolitis by the use of streptomycin has removed one of the serious obstacles to possible eventual recovery.