Use of corticosteroids in conjunction with anti-tuberculous therapy showed a reduction in mortality and morbidity in pericardial and central nervous system TB. Signs and symptoms in pleural and severe pulmonary TB improve rapidly with the addition of corticosteroids. The recent increase in tuberculosis is disturbing and not entirely related to the increase in AIDS. Although corticosteroid therapy has been one of the great therapeutic advances in the history of medicine, for decades it has been appreciated that steroid therapy given to patients with untreated or unrecognized tuberculosis results in overwhelming disease and death. Therefore, it is easy to understand the reluctance to use steroids as adjunctive therapy for tuberculosis when steroids have such a profound effect on untreated tuberculosis.