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Fever and sweating. X-ray shows pleural effusion. TB negative. Reason?

I m a 30 yr old male and had a history of cough and low grade fever for about a month.took antibiotics and it was on and off.Then i developed high grade fever upto 103.on xray chest pleural effusion was found .was hospitalized and pleural tapping was done twice and antibiotic course was also completed.was investigated for TB but all tests were negative except mantoux .so was started on AKT a week back.again developed effusion now and low grade fever upto 101 on and off.i also have night sweats .after i was hospitalized till now ,ive lost 10 kgs.what cud be the reason? how do i know if im following the correct line of treatment?
Asked On : Mon, 12 Nov 2012
Answers:  1 Views:  89
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Internal Medicine Specialist 's  Response
Thanks for writing your query to us.
History of longstanding fever of 1 month duration, cough, significant weight loss along with chest Xray showing pleural effusion as you had mentioned most likely diagnosis is Tuberculosis. Since you had also mentioned that pleural fluid examination done twice is negative for tuberculosis which is unlikely for tuberculosis.
Error in pleural fluid examination can be the cause. Try to get pleural fluid examined from a reliable pathology lab. Pleural fluid ADA(Adenosine deaminase Test) is specific for tuberculosis. If that is negative that diagnosis needs to reevaluated. Tuberculosis takes time to respond to the antituberculosis drugs, so kindly continue the medicines & do not stop the medicines without consulting your treating doctor.
Wish you good health.
Answered: Tue, 13 Nov 2012
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