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Confirmation of TB with Mantoux positive - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Lung and Chest disorders
Answered by

General & Family Physician
Practicing since : 2009
Answered : 667 Questions
User :   hello sir,i have a query to daughter,13years of age is suffering from a problem as her fever is elevating upto 101 degrees each day mostly at evening and less during night and morning.....weight loss:from 40kg to 35kg within 2 months
Symptoms:fever,slight cough,weakness, we are nat able to recognise her problem,also her mantoux test is positive-its25mm ........elisa test --ve.......
kindly suggest something.... i mean some other tests so that we could conform about TB
also her x-rays reports of chest are not very clear...i would also like to know about the avalibility of T spot test for TB in ranbaxy or any other lab in xxxx
Doctor :   Hi
Doctor :   Dr. xxxxx here
User :   sir may know your qualification degrees
Doctor :   i am General Physician
User :   thanks sir,
Doctor :   give me a min
Doctor :   let me read your query
Doctor :   so her Mantoux is positive
User :   yes,
Doctor :   and does has typical symptoms for TB
Doctor :   is she taking any medications ?
User :   no sir,initially doctors declared that she was suffering from pneumnea and typhoid so she had its medicins for 15 days brofore a couple of days
Doctor :   was a sputum test done ??
User :   yes,one time but it came to be negative
User :   medicins she had
User :   7 days-cefapodoxime,after this next 7 days-cefixime then after that she had cefuroxime for further 7 days
Doctor :   ok
User :   and clarithromicin in combination with the previous one...
Doctor :   so the sputum test was done before or after these medications were given ?
User :   it was done after 5 days of discontinuiting these medicins
Doctor :   and it once did came positive right ?
User :   it was recomended by doctors to do this test 3-4 times but we did it only once and it came negative
Doctor :   you see it is a confirmatory test as it allows us to see the micro organism directly
Doctor :   so you should have done it again as per recommended
User :   but sir we are not really satisfied with the reports bcoz it was taken from the throat and not from within from lungs
Doctor :   that does not matter
Doctor :   as sputum test is taken from throat
User :   sir so can we relay on it.....
Doctor :   yes you can as its a confirmatory test
User :   is there any other blood test for confirmation
Doctor :   Medications are the cornerstone of tuberculosis treatment. But treating TB takes much longer than treating other types of bacterial infections. With tuberculosis, you must take antibiotics for at least six to nine months. The exact drugs and length of treatment depend on your age, overall health, possible drug resistance, the form of TB (latent or active) and its location in the body.
User :   sir i mean that can we relay completely on the sputem reports as they came to be negative
Doctor :   A special test to diagnose TB called the PCR (polymerase chain reaction) detects the genetic material of the bacteria. This test is extremely sensitive (it detects minute amounts of the bacteria) and specific (it detects only the TB bacteria). One can usually get results from the PCR test within a few days.
Doctor :   you can get that done
Doctor :   ranbaxy does it in india
User :   and sir what about T spot is it available in ranbaxy
Doctor :   they should have it
Doctor :   its one of the MOST SENSITIVE TEST
User :   so can we go for both PCR and T spot test
Doctor :   yes you can
User :   what if it comes +ve.......what medications should be intaken then...??
Doctor :   it will depend on the extent of bacterial load and also depending on the age of your child medications are given
User :   so how we know about the bacterial loads....from the tests....??
Doctor :   with drug-susceptible cases of TB can be cured more than 95 percent of the time.
Doctor :   yes the test will tell the load
User :   what about TB gold it recomended for my daughter's age(13years)
Doctor :   the above two tests are more than sufficient
User :   what if T spot test is not available in should we go for TB gold?
Doctor :   you should get them and start the treatment as soon as possible
Doctor :   you should inquire about the test
Doctor :   also do repeat the sputum test
User :   i mean is there any age ristriction for TB gold test...??
Doctor :   it can be done in 13 year old
User :   what if all these tests comes to be negative...?
Doctor :   then your daughter does not have TB
User :   what could be other reasons for this fever and weakness??
Doctor :   since mantoux was positive
Doctor :   so the chances are more towards TB
User :   but what if PCR test and Tspot tests comes to be -ve,what could be the reason for fever.....
User :   plz give me a general idea
Doctor :   the reason we do the test is that we can rule out the causes if they come negative then we follow a different approach , yes it can also be typhoid and a lung infection
User :   test for typhoid came to be negative(tiphi test)
User :   and how can we detect the lung infection/
Doctor :   first you need to go for the TB test, and then things are done step by step
Doctor :   a simple blood examination can detect infection
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