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Intermittent fever, weakness, lack of appetite, breathlessness. X-ray showed chest infection and TB skin test. Advice?

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My mother is suffering from intermittent fever for more than 2 months,Restlessness,Weakness,Lack of Appetite,breathlessness.She was detected to have E-coli(Urinal Infection) and have received antiobiotics and medicine for it but was cured. 15 days ago she was prescribed TB medicine by another Doctor. Her X-ray Showd chest infection and TB skin Test was positive but there is no cough at all. Also yesterday her TB Gold test turned out to be negative.
Has the doctor done a mistake and she is not suffering from TB or what.Kindly advise.
Blood test shows Several anomalies in RBCs as well
Posted Fri, 17 May 2013 in General Health
 
 
Answered by Dr. Shailja Puri 26 minutes later
Hello,

Thanks for posting your query on XXXXXXX

I get to learn from your history that your mother suffered from urinary tract infection which has been treated.

On the basis of clinical features (intermittent fever, loss of appetite, weakness, breathlessness), positive skin test (Mantoux test) and findings of X XXXXXXX chest , a diagnosis of TB was made and the treatment was given.

It is not essential to have cough in all cases of TB.
TB gold is not a specific test for TB. Infact it has been banned in India.

The most specific test for TB is a positive culture or a positive PCR.
You can consult your treating doctor for further clarification.

If you have more queries, I will be glad to answer.

Dr Shailja P Wahal


Above answer was peer-reviewed by
 
Follow-up: Intermittent fever, weakness, lack of appetite, breathlessness. X-ray showed chest infection and TB skin test. Advice? 1 hour later
Hi, srry mam in a hurry i wrote e coli has cured but actually hasn't.by pcr did u mean skin test.we are just worried of misdiagnosis. Also fever still persists and other symptoms as well. Mam i know it would difficult fr u to say without reports but do symptoms resemble tb and how much time after she could start getting relief. Although appetite has increased marginally. Thanks mam ft a quick reply.
 
 
Answered by Dr. Shailja Puri 17 minutes later
Hello and welcome again,

PCR is a blood test.

The symptoms that you have mentioned i.e. decreased appetite, intermittent fever, weakness, etc are suggestive of tuberculosis.

These symptoms resolve after taking medication.

Fever may take some time to resolve.
Appetite also improves gradually.

A clinical suspicion and a positive Mantoux test has led your clinical to start anti tubercular treatment (ATT).

Response to ATT further confirms the diagnosis.

The most confirmatory tests are PCR and culture of TB bacteria. However, an examining clinician is always at a better situation to decide the treatment for the patient.

If the urinary tract infection has not resolved then you need to continue the antibiotic under supervision of your treating doctor.

Thanks and take care.
Dr Shialja P Wahal
Above answer was peer-reviewed by
 
Follow-up: Intermittent fever, weakness, lack of appetite, breathlessness. X-ray showed chest infection and TB skin test. Advice? 42 hours later
HI Mam,
As per your advice my mother met with the doctor, who has referred her to another doctor.Also the skin test was also negative but X-ray showed TB.

Can this persistent fever be due to Urinary Traction?As the doctor has prescribed no medicine for urinary traction.

Do we need to see other doctor.

Thanks
XXXXXX
 
 
Answered by Dr. Shailja Puri 7 minutes later
Hello and welcome again,

The urinary tract infection needs to be treated before any other treatment.
TB is not diagnosed on X XXXXXXX chest or by Mantoux test alone.
Microscopic confirmation or culture is needed to confirm TB.

But initially get the urinary tract infection treated, The fever can be due to the infection.
A repeat urine test will help in knowing the infection status currently.

Thanks and take care.
Dr Shailja P Wahal
Above answer was peer-reviewed by
 
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