Hypersensitivity. Presence of acute infections uncontrolled by appropriate antimicrobial therapy. Patients already receiving corticosteroids are more susceptible to infection. The symptoms of which, moreover, may be masked until an advanced stage has been reached.
Patients with active or doubtfully quiescent tuberculosis should not be given corticosteroids except, very rarely, as adjunct to treatment with antitubercular drugs. Patients with quiescent tuberculosis should be observed closely and should receive chemoprophylaxis if corticosteroid therapy is prolonged.
During prolonged courses of corticosteroid therapy, patients should be examine regularly. Sodium intake may need to be reduced and calcium and potassium supplements may be necessary. Monitoring of the fluid intake and output, and daily weight records may give early warning of fluid retention. Back pain may signify osteoporosis.