It has been reported that high dose ICS is associated
with the development of pulmonary TB in persons
with COPD* For this reason, it has been recommended that every patient with COPD should undergo chest radiography, sputum acid-fast smear, and mycobacterial culture before receiving, as well as regularly during, HD ICS therapy. It is suspected, but not proven that this risk would also occur in persons, with a history of TB, who do not have COPD.