What condition may be exacerbated by the use of IV methylprednisolone?

The use of IV methylprednisolone may exacerbate pulmonary infections due to its immunosuppressive properties. Corticosteroids, like methylprednisolone, can reduce inflammation and modulate the immune response, which can have the effect of increasing susceptibility to infections, particularly in individuals who may already have underlying pulmonary issues. By dampening the immune system, the body may be less able to combat existing infections or may have a delayed response to new infections, allowing conditions like pneumonia or other respiratory infections to worsen.

The context of the other options also frames the correct answer. While cardiac arrhythmias, respiratory infections, and gastrointestinal bleeding can all be concerns with corticosteroid use, pulmonary infections specifically relate to the immediate impact of reduction in local immune responses in the lungs. This focus on the respiratory system highlights why pulmonary infections are more directly exacerbated than other possible conditions listed.