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Suggest Treatment For Tuberculosis And High Blood Sugar Levels
Question: Hello,
My Dad is suffering from tuberculosis and high blood sugar, he has been under treatment from last past 11 months earlier the doc told us the treatment may go for 9-12 months.
He is right now on high dose insulin 42:24, in today x ray report i infiltration is shown again while in earlier there was no signs of infiltration. Doc has suggested us for ct scan chest.
Please suggest, what are possible causes for this infiltration, and what steps we need to take further.
How long it will take for complete treatment.
Regards,
My Dad is suffering from tuberculosis and high blood sugar, he has been under treatment from last past 11 months earlier the doc told us the treatment may go for 9-12 months.
He is right now on high dose insulin 42:24, in today x ray report i infiltration is shown again while in earlier there was no signs of infiltration. Doc has suggested us for ct scan chest.
Please suggest, what are possible causes for this infiltration, and what steps we need to take further.
How long it will take for complete treatment.
Regards,
Brief Answer:
Possibility of drug resistant tb should be entertained.
Detailed Answer:
hello XXXXXXX
Thanks for posting your query on HCM.
If your dad is not improving after having taken tb treatment for more than 9 months, possibility of drug resistant tb needs to be entertained.
Development of new infiltrates in the chest x Ray may also point towards that. The chances of MDR TB(Multi Drug Resistant TB ) are high in diabetic patients.
His sputum should be tested for MTB Culture and drug sensitivity to both first and second line tb drugs.
These facilities are only available in tertiary care hospitals be it government or private hospitals. Hence it is better that you take him to one such hospital because treatment of MDR TB is a challenging task.
Possibility of drug resistant tb should be entertained.
Detailed Answer:
hello XXXXXXX
Thanks for posting your query on HCM.
If your dad is not improving after having taken tb treatment for more than 9 months, possibility of drug resistant tb needs to be entertained.
Development of new infiltrates in the chest x Ray may also point towards that. The chances of MDR TB(Multi Drug Resistant TB ) are high in diabetic patients.
His sputum should be tested for MTB Culture and drug sensitivity to both first and second line tb drugs.
These facilities are only available in tertiary care hospitals be it government or private hospitals. Hence it is better that you take him to one such hospital because treatment of MDR TB is a challenging task.
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Hello,
We are visiting metro hospital in XXXXXXX we had undertook the 13 drug test around 2-3 months ago and all the drugs are sensitive to it, we continued the medical treatment as suggested.
But major concern is he has clear x ray 2 months ago now some infiltration is there, doctor are suggesting it might be old scar in shadow and right now going for cect chest(ct scan).
Please suggest what precaution we need to take care of and how we need to proceed further do we need to refer to some other doctor or hospital which are better for these cases.
Regards,
XXXX
Besides this there is no signs of fever or weight loss .
Everthing is normal but some rise in blood sugar level is seen from past 2-3 days.
Regards,
We are visiting metro hospital in XXXXXXX we had undertook the 13 drug test around 2-3 months ago and all the drugs are sensitive to it, we continued the medical treatment as suggested.
But major concern is he has clear x ray 2 months ago now some infiltration is there, doctor are suggesting it might be old scar in shadow and right now going for cect chest(ct scan).
Please suggest what precaution we need to take care of and how we need to proceed further do we need to refer to some other doctor or hospital which are better for these cases.
Regards,
XXXX
Besides this there is no signs of fever or weight loss .
Everthing is normal but some rise in blood sugar level is seen from past 2-3 days.
Regards,
Brief Answer:
Let him continue the treatment as advised by his treating physician.
Detailed Answer:
If clinically he is improving with weight gain, no fever , cough etc and the drug sensitivity test did not show any resistance, chances of drug resistant tb are less.
As of now you continue the treatment as advised by his treating physician and get the CT Chest done. We have to wait for the CT report to decide the further course of action. No other special precautions required.
Let him continue the treatment as advised by his treating physician.
Detailed Answer:
If clinically he is improving with weight gain, no fever , cough etc and the drug sensitivity test did not show any resistance, chances of drug resistant tb are less.
As of now you continue the treatment as advised by his treating physician and get the CT Chest done. We have to wait for the CT report to decide the further course of action. No other special precautions required.
Above answer was peer-reviewed by :
Dr. Veerisetty Shyamkumar
Hello,
I had uploaded the previous(around 10 months ago) and today ct scan report. In between we had xray which are clear.
Can you please consult.
Regards,
I had uploaded the previous(around 10 months ago) and today ct scan report. In between we had xray which are clear.
Can you please consult.
Regards,
Brief Answer:
There may be marginal improvement.
Detailed Answer:
Having compared both the CT reports, i am of the opinion that there is no significant difference in both of them. However there is no detiroration as such and if anything, one can say that there may be marginal improvement.
Sometimes radiological improvement ay take a long time and at times some of the changes in lungs in tb patient may remain permanently.
Since you say that he is otherwise improving and his drug sensitivity reports were normal, you may continue the treatment and duration of treatment may be extended to one year in consultation with his treating physician.
There may be marginal improvement.
Detailed Answer:
Having compared both the CT reports, i am of the opinion that there is no significant difference in both of them. However there is no detiroration as such and if anything, one can say that there may be marginal improvement.
Sometimes radiological improvement ay take a long time and at times some of the changes in lungs in tb patient may remain permanently.
Since you say that he is otherwise improving and his drug sensitivity reports were normal, you may continue the treatment and duration of treatment may be extended to one year in consultation with his treating physician.
Above answer was peer-reviewed by :
Dr. Nagamani Ng
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