Detection of Antibodies Against Mycobacterium tuberculosis
نویسنده
چکیده
Communications to the Editor admission for treatment ofsevere respiratory dysfunction. The time lapse between appropriate medical treatment and deterioration in our patients varied from two to seven months. Our patients also differed in having negative mycobacteria cultures in the sputum, bronchial washes and the endobronchial granuloma biopsy unlike the “reactivation” of tuberculosis which was suggested by Dr. Munoz-Gutierrez. Late clinical deterioration, absence ofmycobacteria in the endobronchial granuloma and the response to glucocorticoids indicates an inflammatory or immune response. The classic Jarisch-Herxheimer reaction (JHR) occurs within 24 h after therapy; bacterial “endotoxins” have been imphcated. Glucocorticoids can suppress the severity ofthis JHR. The early deterioration oftreated tuberculosi? resembles the JHR except it occurs later than 24 h. In view of the natural life history of mycobacteria tuberculosis infection coupled to tuberculosis chemotherapy with resultant slow growth and continuing bactenocidal activity, this late reaction is not surprising.78 Despite the late reaction in our patients, we are of the opinion that there was an altered immune response during tuberculosis chemotherapy which clinically resembled a Jarisch-Herxheimer Beaction.
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