[From the aspects of complicated diseases].

Pulmonary tuberculosis is one of the most prevalent infectious diseases in Japan. Host defense mechanisms may play an important role in every aspect of the disease, for example in acquiring the disease and/or in progression of the clinical course. Host defense mechanisms are constituted from mechanical protection such as cough or sneeze, chemical resistance such as complements or lactoferrin, nonspecific cellular defense such as macrophages or neutrophiles and specific immunological defense mechanisms such as immunoglobulins or immunocompetent cells. If there were any complicated disease other than pulmonary tuberculosis, the disease outcome might become different. We examined 44 patients whose sputa culture was continuously positive for one year or more, despite of administration of anti-tuberculous regimens. And we also analyzed clinical outcome of 556 patients with pulmonary tuberculosis (control group) who were discharged after bacteriological negative conversion. Diabetes mellitus is one of the most common complications in patients with pulmonary tuberculosis, 11/44 in continuously positive patients and 101/580 in control group. There was no statistical significance between these two. Next, the control group was divided into four subgroups, those were 1. no complication, 2. complicated with diabetes mellitus, 3. complicated with liver dysfunction, 4. complicated with the other diseases. Bacteriological negative conversion rate was analyzed in these four subgroups. At the first and the second month, there were significant difference in negative conversion rate between subgroup 1 and 2. But these differences disappeared as the time goes by.