Sputum-positive coalworker's pneumoconiosis and drug therapy

Five cases with unmodified pulmonary tuberculosis in the presence of simple pneumoconiosis responded clinically and radiologically to combined drug therapy.

In contrast, little response to therapy was evident in 17 cases with positive sputa and progressive massive fibrosis. Of these cases 2 improved and 2 died, and none of the remainder showed cavity closure or a definite sputum conversion. Some cases developed drug-resistant tubercle bacilli.

The importance of classifying cases with progressive massive fibrosis by disease extent, before assessing fatality rates, is stressed.