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Suggest Treatment For Resistant TB Infection
Question: Hello Doctor, I have dignosesd with Tuborclosis. My history is in the same blog. I am taken care by Dr. XXXXXXX Danoda. I have taken forecox for around 3 month. Now I have taking only R-Cinex 600,300 and BECOSULES.But till today , I have feel low grade fever( Around 99F) all time.
Problem is that, I have lymp node. When i started taking madicin that was started to decreasing.But now i feel it is increasing again.
May I know the reason. What do you say about my curing procedures. Please suggest.
Problem is that, I have lymp node. When i started taking madicin that was started to decreasing.But now i feel it is increasing again.
May I know the reason. What do you say about my curing procedures. Please suggest.
Brief Answer:
you may need excision biopsy of lymphnode.
Detailed Answer:
Hi XXXXXXX thanks for your question on HCM.
You may have drug resistant TB infection in your lymphnode. I am suspecting this because
1. Swelling increasing in size inspite of treatment.
2. You have 99F temparature.
3. And you have taken 3 months of treatment so if it is drug sensitive tb than swelling should decrease in size.
For diagnosing this you need excision biopsy of your lymphnode and do AFB culture and sensitivity of this. If in this report you find Resistance to rifampicin than you are having drug resistant TB(DRTB). And treatment is entirely different for DRTB. Treatment duration is also more, atleast 24 months.
And at present you are on proper medicines for TB. So continue same Rcinex and becosule and get done excision biopsy and AFB culture sensitivity to rule out DRTB.
The culture and sensitivity report takes atleast 20-30 days to come.
Till this time continue with Rcinex and becosule.
Don't worry as DRTB is 100% curable.
Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.
you may need excision biopsy of lymphnode.
Detailed Answer:
Hi XXXXXXX thanks for your question on HCM.
You may have drug resistant TB infection in your lymphnode. I am suspecting this because
1. Swelling increasing in size inspite of treatment.
2. You have 99F temparature.
3. And you have taken 3 months of treatment so if it is drug sensitive tb than swelling should decrease in size.
For diagnosing this you need excision biopsy of your lymphnode and do AFB culture and sensitivity of this. If in this report you find Resistance to rifampicin than you are having drug resistant TB(DRTB). And treatment is entirely different for DRTB. Treatment duration is also more, atleast 24 months.
And at present you are on proper medicines for TB. So continue same Rcinex and becosule and get done excision biopsy and AFB culture sensitivity to rule out DRTB.
The culture and sensitivity report takes atleast 20-30 days to come.
Till this time continue with Rcinex and becosule.
Don't worry as DRTB is 100% curable.
Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
I have done some tests and please go through with test rpeort as an attachment.
And please tell me about thar test if any thing going wrong.
Thanks
And please tell me about thar test if any thing going wrong.
Thanks
Brief Answer:
Get an Ultrasound abdomen done.
Detailed Answer:
Hi XXXXXXX
I have gone through your reports.
Your liver enzymes are slightly elevated with high GGT level. Which suggest some hepatocellular damage. But your billirubin levels are normal. So no need to worry much. But please get done ultrasound abdomen for liver parenchyma. This will tell you whether liver damage is there or not.
Regarding your CBC,
Your Total count is slightly raised with raised lymphocytes with high ESR, all suggest some chronic infection like TB.
So chances of Multi Drug Resistant(MDR) TB is high. So please get done excision biopsy of your lymphnode and do culture for AFB and sensitivity to rule out MDR TB.
Hope I have solved your query. If you are not having any further queries, please close the conversation and rate the answer.
Thanks.
Get an Ultrasound abdomen done.
Detailed Answer:
Hi XXXXXXX
I have gone through your reports.
Your liver enzymes are slightly elevated with high GGT level. Which suggest some hepatocellular damage. But your billirubin levels are normal. So no need to worry much. But please get done ultrasound abdomen for liver parenchyma. This will tell you whether liver damage is there or not.
Regarding your CBC,
Your Total count is slightly raised with raised lymphocytes with high ESR, all suggest some chronic infection like TB.
So chances of Multi Drug Resistant(MDR) TB is high. So please get done excision biopsy of your lymphnode and do culture for AFB and sensitivity to rule out MDR TB.
Hope I have solved your query. If you are not having any further queries, please close the conversation and rate the answer.
Thanks.
Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
I have done Ultrasound abdomen 3 month before and the output was 'Enlarge Liver'.
Rest of the things was fine.
Rest of the things was fine.
Brief Answer:
Get done excision biopsy and culture sensitivity.
Detailed Answer:
Hello XXXXXXX
Thanks for your query again.
In my opinion you should check your liver enzymes every 3 monthly and look for any rise in liver enzymes.
So no need to worry for liver enzymes and enlarged liver at present but keep watch on enzymes every 3 monthly.
And get done excision biopsy of lymphnode and culture for AFB and sensitivity for first line AKT drugs.
Hope I have solved your query. You can question me directly on HCM too. If you are not having further queries, please close the discussion and rate the answer.
Thanks.
Get done excision biopsy and culture sensitivity.
Detailed Answer:
Hello XXXXXXX
Thanks for your query again.
In my opinion you should check your liver enzymes every 3 monthly and look for any rise in liver enzymes.
So no need to worry for liver enzymes and enlarged liver at present but keep watch on enzymes every 3 monthly.
And get done excision biopsy of lymphnode and culture for AFB and sensitivity for first line AKT drugs.
Hope I have solved your query. You can question me directly on HCM too. If you are not having further queries, please close the discussion and rate the answer.
Thanks.
Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
I have done FNAC of my lymp node. Report has been attached. Please see that.
Brief Answer:
get done fresh report of excision biopsy.
Detailed Answer:
Hello XXXXXXX thanks for your query.
I have gone through your report. It is 3 months old report. At the time of treatment initiation.
So on the basis of this report you had given AKT.
But in your history you said that the swelling has increased in size, you are having 99F temperature all the day, with high WBC and lymphocytes, high ESR, all suggest possibility of Drug Resistant TB (DRTB).
And to diagnose DRTB , we should have culture and sensitivity report.
Excision biopsy is far superior than FNAC in diagnosing DRTB.
So I adviced excision biopsy and culture sensitivity.
The other report shows elevated liver enzymes, it may be due to medications.
Hope it is clear now.
You can ask me directly also. Please don't forget to rate the answer. Thanks.
get done fresh report of excision biopsy.
Detailed Answer:
Hello XXXXXXX thanks for your query.
I have gone through your report. It is 3 months old report. At the time of treatment initiation.
So on the basis of this report you had given AKT.
But in your history you said that the swelling has increased in size, you are having 99F temperature all the day, with high WBC and lymphocytes, high ESR, all suggest possibility of Drug Resistant TB (DRTB).
And to diagnose DRTB , we should have culture and sensitivity report.
Excision biopsy is far superior than FNAC in diagnosing DRTB.
So I adviced excision biopsy and culture sensitivity.
The other report shows elevated liver enzymes, it may be due to medications.
Hope it is clear now.
You can ask me directly also. Please don't forget to rate the answer. Thanks.
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
Answered by
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