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On anti-TB treatment, have persistent fever, prescribed Prednisolone, ATT. What should be my next step?

I m 55 years old Indian male, non veg, smoker, alcoholic(2 drinks daily since 30 years). I lost about 12-15 Kgs of weight in about 3 months though the appetite has been normal. I was passing loose stools(4-5) for over a month without any blood.I also have been running fever (99 F) for the last so many years. The fever starts in the afternoon & lasts till 10pm in the night. Even now the fever is persisting. Further since last 6 months, my urine samples show 3-5 RBC s as well as proteins . I have undergone various tests of blood such as Thyroid, Sugar, Hemogram, LFT, Kidney Function tests, HIV , Hepatitis B & C, Repeated Stool examinations. The CT scans for Chest, Abdomen & Prostrate condcted recently do not show any growth or any abnormality. I have also undergone Colonoscopy which shows 2-4 mm Multiple Active Erosions in the Ileo-ceacal Region for which either TB? or Crohn s?? is indicated in the report. Thus the doctors have put me on Anti TB treatment & for the past 4 weeks I am on ATT. Though the weight loss has been arrested but it has not shown any increase, afternoon fever still persisting. I have been told to add Prednisolon 20 mg daily along with ATT but I m yet to take this medicine. Can you guide me about the treatment & future course
Asked On : Thu, 10 May 2012
Answers:  1 Views:  256
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Pulmonologist 's  Response
hello dhir

thank you for your question

i have read your problem and i would like to tell you that fever in case of tuberculosis fever may persist for about 2months on therapy. sometimes it can be due to systemic response for which steroids is usually benefecial, so i would advice you to take prednisolone for a fortnight. considering your weight loss i would recommend you a colonoscopic biopsy to confirm the diagnosis. continue your anti tubercular therapy with 2months of intensive phase and 4months of continuation phase.
kindly revert us back with the biopsy report so that we can advice you for further plan of treatment.

wish you a good health and success

Dr. Gurpreet Narula
Answered: Fri, 13 Jul 2012
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