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Suggest Medication For TB

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Posted on Mon, 9 Nov 2015
Question: My mother is detected with TB. She has undergoing the 4 medicines Pyzina 1000, R-Cinex 600, Mycobutol 1000,benadon 40 for 3 weeks and 2 days. But there is no improvement.
From day 1 she is having low grade fever I.e. less than 100 and that too in evening with absolutely no coughing. Same condition still persists even after 3 weeks of medication.

Xray bad parenchymal opacity in left lower zone and right lower zone. Rest of lung fields are clear.
Cect thorax ct had areas of patchy subsegmental pneumonic consolidation in Lowe bilateral lobes. Patchy ground glass shadowing in bilateral mid lower zones. Gold test was positive with TB and so was montoux. Please help me understand if I need to consult someone else.
doctor
Answered by Dr. Drkaushal85 (1 hour later)
Brief Answer:
Better to get done broncoscopy and XXXXXXX analysis.

Detailed Answer:
Thanks for your question on Health Care Magic.
I can understand your concern.
Yes, you should definitely consult pulmonologist again.
Tuberculosis is common in upper lobes.
It can be seen in lower lobes if patient is diabetic or immunocompromised.
And her CT thorax result is more suggestive of bacterial pneumonia rather than tuberculosis.
Ideally in such patients, bronchoscopy and XXXXXXX analysis should be done.
This will be helpful in Isolation of causative organism.
If this is tb than XXXXXXX will show AFB (acid fast bacilli-bacteria causing tuberculosis).
By doing XXXXXXX culture, we can isolate bacteria (other than tuberculosis) also.
Usually recovery is expected after 1-2 weeks in tuberculosis.
Since she is not improving after almost 23-24 days, better to consult pulmonologist and first diagnose which infection she is having and than start appropriate treatment.
Hope I have solved your query.
I will be happy to help you further.
Wishing good health to your mother. Thanks.
Above answer was peer-reviewed by : Dr. Sonia Raina
doctor
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Follow up: Dr. Drkaushal85 (2 hours later)
Sputum test on day 1 didn't had Afb. We are waiting for week 1 report and 2 month report. So if there was TB should it be visible on day 1.
Also could you suggest some good Doctor in XXXXXXX XXXXXXX area.
doctor
Answered by Dr. Drkaushal85 (1 hour later)
Brief Answer:
Yes, with these much infection on CT scan, sputum should be positive.

Detailed Answer:
Thanks for your follow up question on HCM.
I can understand your concern.

Her CT thorax report is suggestive of a lot of infection.
If this is tuberculosis than sputum is mostly positive with the amount of infection she is having.
So better to consult pulmonologist and get done broncoscopy and XXXXXXX (bronchoalveolar lavage) analysis. XXXXXXX is more superior than sputum examination in identifying infection.
Get done XXXXXXX analysis for AFB and routine culture and sensitivity to identify causative organism.
In XXXXXXX metro hospital is good.
Or you can consult XXXXXXX XXXXXXX Pulmonary department in XXXXXXX is also good.

Hope I have solved your query.
If you are not having further queries, then please close the conversation and rate my answer.
You can ask me directly on bit.ly/askdrkaushalbhavsar.
Wishing good health to your mother. Thanks.


Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Drkaushal85 (1 hour later)
My mom had swine flu in Feb this year. Is that any way result this but she was fine from mar to sep.
Also sputum Afb and XXXXXXX culture is being done. But that takes 2 months.
doctor
Answered by Dr. Drkaushal85 (10 minutes later)
Brief Answer:
What are her exact symptoms?

Detailed Answer:
Thanks for your follow up question on HCM.
I can understand your concern.
You are now confusing me.
Please let me know
1. Bronchoscopy and XXXXXXX analysis done or not?
2. What are her symptoms?
3. Was she totally asymptomatic between March to September?
Please reply me answers of above asked questions, so that I can guide you better.
I will be happy to help you further.
Wish you good health. Thanks.
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Drkaushal85 (2 hours later)
Doctor prescribed Afb and XXXXXXX culture of sputum. No bronchoscope. We did this las thursday. Afb was not seen in that day report. Culture report will take time.

She was fine from mar to sep and in sep developed the low grade fever.

Currently her symptom is low grade fever and pain in leg which may or may not be related.
doctor
Answered by Dr. Drkaushal85 (9 hours later)
Brief Answer:
For XXXXXXX bronchoscopy is must.

Detailed Answer:
Thanks for your follow up question on HCM.
You are mostly misunderstanding XXXXXXX XXXXXXX is bronchoalveolar lavage. And this is done only through bronchoscope.
Bronchoscope is introduced in the lungs through nose. Than from the segment of interest (lower lobes in your mother's case), sample is taken under direct vision.
This whole procedure is known as bronchoscopy and XXXXXXX analysis.
You must be misunderstanding XXXXXXX with sputum. XXXXXXX sample is very much aseptic and highly specific while sputum is almost always contaminated and less specific.
So please let me know
1. XXXXXXX is done or not?
2. Is she having cough?
3. Is she having weight loss, decreased appetite?
4. Was chest x ray after swine flu normal?
Please reply me answers of above asked questions, so that I can guide you better.
I will be happy to help you further.
Wishing good health to your mother. Thanks.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Drkaushal85

Pulmonologist

Practicing since :2008

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Suggest Medication For TB

Brief Answer: Better to get done broncoscopy and XXXXXXX analysis. Detailed Answer: Thanks for your question on Health Care Magic. I can understand your concern. Yes, you should definitely consult pulmonologist again. Tuberculosis is common in upper lobes. It can be seen in lower lobes if patient is diabetic or immunocompromised. And her CT thorax result is more suggestive of bacterial pneumonia rather than tuberculosis. Ideally in such patients, bronchoscopy and XXXXXXX analysis should be done. This will be helpful in Isolation of causative organism. If this is tb than XXXXXXX will show AFB (acid fast bacilli-bacteria causing tuberculosis). By doing XXXXXXX culture, we can isolate bacteria (other than tuberculosis) also. Usually recovery is expected after 1-2 weeks in tuberculosis. Since she is not improving after almost 23-24 days, better to consult pulmonologist and first diagnose which infection she is having and than start appropriate treatment. Hope I have solved your query. I will be happy to help you further. Wishing good health to your mother. Thanks.