Chronic nontuberculous pulmonary infections and their sequelae.

The role of chronic nontuberculous infections as a cause of human misery and disability has not been adequately appreciated. The Initial, causative factor, primarily seemingly insignificant and justifying scant consideration, may eventually pass through a series of conditions, leading in the end to invalidism and even death. It Is my purpose In this paper briefly to sketch the course of chronic nontuberculous infections from the beginning through their progressive stages to their end results, such as, pulmonary fibrosis, cavitation, and bronchiectasis. It is impossible to deal separately and fully with each of the etiologic agents involved in these infections, but reference will be made to the role of chronic lobar and chronic bronchopneumonia, aspiration pneumonitis, atelectasis, pneumonoconiosls, bronchial and bronchiolar stenosis, metastatic lung infections, the mycoses and syphilis, as well as the milder, but quite Important, chronic infections of the nasaopharynx and bronchi. It is necessary to stress the role in the initial development of these chronic infections of such conditions as acute nasosinusitis, subacute bronchitis, and the acute pneumonias. A closer cooperative understanding between the nose and throat specialist and the general practitioner would be helpful in diagnosing and eradicating suppurative conditions of the nasal sinuses. These Infections are often given palliative treatment, only to recur each winter, until a chronIc bronchitis and eventually a chronic pneumonitis and bronchiectasis may develop. The dreadful end results could be, in many cases, obviated in the beginning by prompt treatment, and by carefully following the patients through to a cure. Patients following attacks of acute pneumonia should be regularly checked for the presence of residual foci of infection in their lungs; small atelectatic areas, single or multiple, small bronchopneumonic areas, and slight abscesses, may be found to reward us for our diligence.