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Suggest Treatment For TB And Ear Infection

Posted on Tue, 17 Feb 2015

Question: Dr XXXXXXX

My Mom of 61 years has been diagnosed with TB , she was put on medicines in mid-december , sharing the history below. It's a transcript from my questions posted on healthcaremagic.com

Now after a month of streptomycin since the last 10 days she has been feeling very dizzy while walking or standing to an extent that she needs to take the support of a wall to walk. TB doctors referred us to get her checked for ear infection and get checked by a neurologist. her TB medications have been stopped temporarily.

The most recent meds given to her are : acuvert 5 mg , cinzane 25dt ,merislon 12 mg. Earlier she was taking an anti-vertigo med vertin.

I am worried that we might be giving an over-dose of meds to her while keeping aside her TB. Do you think these medications are necessary at this stage ? How do we treat TB next now? In your experience have you seen such cases and what do you typically suggest?

Thank you for your help
Best,
XXXX
Transcript history:

Hi Doctor,

Thank you for your advise a few weeks back, my mom's tests led to diagnosis of TB as she had fluid around her lungs. The doctor has prescribed the following medicines for curing TB and she is facing a few symptoms since she started these medicines, request your advise on (1) are these medicines right? (2) are there any alternates to these medicines (3) could these side effects be linked to the TB medicines? (4) what can we do to control these side effects?

TB medicines prescribed : RCI NEX , Combutol, Lerobact, Bendadon, Omnacortil.

I look forward to your recommendations.

Best Regards,
XXXX

Thank you Dr. Naval for your advise. Her doctor has replaced her medicines - R cinex and Levolflox with daily injection of streptomycin, they are continuing combutol. In addition the neurologist has given an anti-fit tablet and the TB doctor has prescribed a tonic for protecting liver.

Please advise if Streptomycin in your opinion is the right way to go? On her day 1 today she feels much better and has shown none of the previous mentioned side effects.

The injection will be a daily dose for 2 months.

Answered by Dr. Sudhir Kumar (26 minutes later)

Brief Answer:
Can you get back with more details?

Detailed Answer:
Hi Ms XXXXXXX

Thank you for posting your query.

I have noted your mother's symptoms, diagnosis and medications used.

I need some more details.

1. What are her current medications?

2. What are her current symptoms?

Please get back with these details.

Best wishes,
Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, XXXXXXX
For DIRECT QUERY to me: http://bit.ly/Dr-Sudhir-kumar
My blog: http://bestneurodoctor.blogspot.com/

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Sudhir Kumar (59 minutes later)

Hi Doctor,

Her symptoms are dizziness and vertigo while walking or standing. She is fine when she is sitting or lying down.

I shared the current meds in the previous email.

I forgot to mention she is diabetic

Thanks
XXXX

Answered by Dr. Sudhir Kumar (12 hours later)

Brief Answer:
Anti-Tb medications should be re-started.

Detailed Answer:
Thank you for getting back.

For dizziness and vertigo, one tablet of betahistine 16 mg can be given three times daily. Other medicines can be stopped.

Also, we need to re-start TB medications, as at least six months of treatment are necessary to cure TB.

We should avoid streptomycin, as this can damage the vestibular nerve, resulting in more dizziness and vertigo.

Best wishes,

Dr Sudhir Kumar MD DM (Neurology) XXXXXXX Consultant Neurologist

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar