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Pulmonary Tuberculosis

Leroy Hyde, M.D.
JAMA. 1961;177(12):882. doi:10.1001/jama.1961.03040380060018.
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To the Editor:—  A recent inquiry about a patient with pulmonary tuberculosis (JAMA176:973 [June 17] 1961) was answered thoroughly, but greater emphasis on conservative medical management appears indicated. The patient had tuberculosis in 1940. She had a relapse in 1960 and received isoniazid (INH) therapy for the first time, responding very well with rapid closure of cavity and sputum conversion. Experience has revealed that the vast majority of such patients stay well and do not require surgery. INH alone is continued for 3 to 4 years after discharge from the hospital, and relapse rates are about 1%. The open-negative tuberculosis patient also does well without surgery and with long-term INH therapy (Hyde, L.: Review of 170 Open-Negative TB Cases: To be published; Wilson, T. M., Doyle, L., and Gardiner, M. P.: Open Healing of Tuberculosis Cavities; Results in 40 Patients Treated Conservatively, Brit Med J2:87-90 [July


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