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The authors have observed 6 cases of acute respiratory distress syndrome (ARDS) of tuberculous origin. The condition presented as pulmonary oedema in 4 cases and as extensive bilateral pneumonia in 2. Pulmonary oedema was treated by artificial ventilation with intermittent positive pressure in 2 patients who died, and by continuous positive airway pressure in 2 patients who survived. The 2 patients with pneumonia survived without respiratory assistance. In these patients with atypical symptoms, early diagnosis (which may involve liver and bone marrow biopsies) and immediate therapeutic measures are life-saving. The diagnosis of tuberculosis should be systematically considered in adult ARDS, especially i patients with pulmonary oedema of unknown origin.

Reversible acute renal failure was observed in 13 patients after combined antibiotic therapy using gentamicin. High and prolonged doses were used in 7 patients whose initial renal function was normal, while 6 other patients with preceding chronic renal insufficiency received usual doses of gentamicin. Precipitating factors were: increasing age, previous renal impairment, and combined use of other antibiotics, mainly cefalotin (8 patients). The nephrotoxicity of gentamicin is poor but well established, and may be prevented by checking the initial renal function, adjusting the dosage subsequently, and monitoring the renal function and gentamicin serum levels during therapy.