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Tuberculosis pleural effusion in the right lung

My father developed severe productive cough in October 2010 and within next ten days ATT was started based on X Ray showing Right Pleural effusion , tests on the fluid in the right lung showed no AFB, however high ADA indicative of Tuberculosis was observed, high ESR ~ 68 , 3 consecutive sputem samples showed no positive AFB, after two months of ATT, X Ray shows no change and ESR is 84 which has actually increased, though cough is much reduced in intensity but still persists could you pl. suggest reason why even after 2 Months of ATT there is no change in X-Ray and ESR is still so high, Thank you so much
Asked On : Tue, 11 Jan 2011
Answers:  3 Views:  531
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General & Family Physician 's  Response
As you told your father on Anti TB medications since 2 months and on repeat x ray there is no change, plz get it in your mind first that if this is TB you should complete the whole course of treatment as Cat I ( red box tablets) in govt institution.
After completing 6 months treatment if the disease is TB ( not multi drug resistant TB) will get cured. But mostly the X ray changes persists for several days. If there is sever tubercular pleural effusion it must get drained by Physician by Tapping or By Intercostal drain.
Rise of ESR is not particular for TB, it is seen in most of chronic diseases.
Answered: Tue, 11 Jan 2011
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  User's Response
Thank you so much.
Answered: Wed, 12 Jan 2011
General & Family Physician Dr. Raju A.T's  Response

Welcome to Healthcaremagic Forum

Two weeks of ATT will render the patient non infective in TB, thats the primary goal as its a communicable disease and treatment for 15 days to one month will reduce the bacterial count such that the sputum positive becomes negative .Hence ATT kills the bacteria but do not involve in the healing of the lesions already formed by TB , the healing should take place by nature . Pleural effusion and ESR are indicators of inflammation but not the infection.

If effusion is minimal it will get absorbed on its own, in moderate to severe cases drainage of the fluid is necessary by intercoatal aspiration.ESR is a chronic finding will take months to get normal after infection is cured. Hence complete the course of the ATT to clear the infection and prevent relapse which is very common.

Thanks for visiting Healthcaremagic .com

Answered: Wed, 12 Jan 2011
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