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Are Rcinex, Pyzina And Combutol Effective At Treating Cold Abscess Chest Wall And Tuberculosis Infection?

Posted on Wed, 10 Oct 2018

Question: Hello Doctor- Two months back I was dignosed with Cold Abscess Chest Wall on left side with other symptoms are evening fever, weigh loss , cough. FNAC of pus from Chest wall was done and it was confirmed as Tuberculosis infection.
Genexpert- Tuberculosis Detected with Rifampcin Sensitive.
Chest Xray- Lobulated opacity is noted along the pleura.
Below medicines were Started based on body weigh 58Kg
Rcinex 600Mg
Pyzina 1750Mg
Combutol 1200Mg
Also the pus was sent for Culture & Sensitivity test.
In the 7th week growth of Mycobacterium tuberculosis complex was detected with below sensitivity report
Streptomycine: Sensitive
Isonizaid:Sensitive
Rifampicin:Sensitive
Ethambutol:Resistance
Pyrazinamide:Sensitive
Based on the above report Ethambutol Resistance the doctor has modified the regime as
Rcinex(600) for another 6-9 months
Pyzina continue upto 3-4 months
Levolfoxcin(1000) for another 6-9 months.
Also below are the clinical improvements after two monts
- Have gained around 3kgs of weight
- No fever now
- Cough Redecued
- Chest wall swelling reduced but still not completely resolved

I need to check if above modified regime of the medicines correct and duration how long they need to be continued.
Also if the treatment is on the right track.

Answered by Dr. Drkaushal85 (35 minutes later)

Brief Answer:

Yes, treatment duration and drugs are appropriate.

Detailed Answer:

Hello,

I have gone through the drug list you have mentioned.
Your treatment is going on right track.

You are improving clinically so no need to worry much.
Your swelling will definitely reduce after completion of treatment.
So stick to these drugs for entire treatment duration.

Usually, we give 10-12 months of treatment for complete cure.

Hope I have answered your query. Let me know if I can assist you further.

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Drkaushal85 (20 minutes later)

Thanks but I need to check if Levoflox is given for the treatment of Tuberculosis.Also generally to my knowledge Pyzina is discounted after initial two months.But my current doctor is saying to continue Upto 4 months.

Answered by Dr. Drkaushal85 (53 minutes later)

Brief Answer:

Extra pulmonary tuberculosis needs longer treatment.

Detailed Answer:

Hello,

Yes, you are right.
But this is true for pulmonary tuberculosis.
Extra pulmonary tuberculosis needs longer treatment.

Usually, we give Rifampicin, isoniazid (Rcinex), pyrazinamide (Pyzina) and ethambutol (combutol) for first 2 months and Rcinex and ethambutol for the next 4-5 months.

But for extrapulmonary tuberculosis, we give drugs for a longer duration. So no harm in taking pyrazinamide for 4 months.

Your report is suggestive of ethambutol resistance. So ethambutol is replaced by levofloxacin in your case.
No harm in continuing levofloxacin along with Rcinex for 10-12 months.

You should take treatment for at least 10-12 months.

Hope I have answered your query. Let me know if I can assist you further.

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Drkaushal85 (22 hours later)

Thank you doctor.Just need to confirm with above medicines the chest wall cold abscess will resolve over the period of time.

Answered by Dr. Drkaushal85 (14 hours later)

Brief Answer:

Yes, it will definitely resolve.

Detailed Answer:

Hello,

Yes, your swelling should definitely subside with these drugs.
No need to worry much about this.

Hope I have solved your query. If you are not having further queries, then please close the conversation and rate my answer.

Hope I have answered your query.

Take care

Regards,
Dr Kaushal Bhavsar, Pulmonologist

Above answer was peer-reviewed by : Dr. Arnab Banerjee