Tuberculosis presenting as corticosteroid responsive wheezing in infancy.

A nine-month-old child received intermittent oral prednisolone over a 6 month period because of persistent wheezing. This therapy had appeared to improve his symptoms. At 15 months of age, a chest X-ray and culture of tracheal aspirate revealed disseminated pulmonary tuberculosis. Response to antituberculous therapy was slow, and withdrawal of steroids produced marked worsening of wheeze and respiratory distress. Corticosteroids are recognised adjuncts in the management of bronchial-lymph node tuberculosis. Responsiveness of wheezing to prednisolone does not imply that its cause is hyperreactive airways disease, and other causes should be sought particularly in developing countries.