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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Blood In Sputum After Taking Treatment For TB?

MY SON 25 YEARS HEIGHT 5 . 8, WEIGHT 78, WAS DETECTED WITH LUNG t.b 5 yars back. he does not smoke.Zeed 4 was prescribed. I doubt whether he continued without fail for the 9 months prescribed. Later HE HAD TO UNDERGO A STOMACH SURGERY AND HIS COLON HAD TO BE CUT SINCE THERE WAS A MASS WHICH ON BIOPSY WAS DETECTED AS HEALED t.b. again after 5 years he coughed on taking hot tea in the morning . sputum was tinged with blood. and later mouth full of blood came on coughing. xray was clear. but on ct scan a small cavity 8 mm was detected in the upperlobe exactly in the same positio where he had had t.b formerly.so doctor started akt 4. when he had t.b before there was considerable weight loss and was had no immunity. but now he has good weight perhaps overweight and is not sick at all. But doctor stated anti t.b to avoid risk. i think doctors are divided on dosage. when one doctor says he can reduce the dosage after 3 months the doctor who knows the prior history better is of opinion that he shuld take the medicine intensive course for 5-6 months and then continuing course for another 6 months. any side effect? also i came across a different opinion that he is not having T.B AND THE BLEEDING MAY HAVE BEEN DUE TO SOME CAPILLERY BRAK FROM THE PREVIOUSLY AFFECTED PART. I AM CONFUSED CAN U HELP?
Wed, 20 Aug 2014
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Pulmonologist 's  Response
Yes you are right. TB in past leaves back an area of healing in the lung. It may be fibrosis or calcification or bronchiectasis. And in all these capillary bleeding is possible due to excessive coughing. So it is not a dictum that you should always start AKT in bloody sputum. In my opinion that 8 mm small lesion may be just a healed area. Since your son is asymptomatic you should undergo some tests like sputum for AFB. If this is negative go for bronchoscopy and BAL analysis. . If all these negative than it is less likely due to tb. So you can wait for AKT. And intensive phase usually given for 3 months no need to give further if you are responding to the treatment.
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What Causes Blood In Sputum After Taking Treatment For TB?

Yes you are right. TB in past leaves back an area of healing in the lung. It may be fibrosis or calcification or bronchiectasis. And in all these capillary bleeding is possible due to excessive coughing. So it is not a dictum that you should always start AKT in bloody sputum. In my opinion that 8 mm small lesion may be just a healed area. Since your son is asymptomatic you should undergo some tests like sputum for AFB. If this is negative go for bronchoscopy and BAL analysis. . If all these negative than it is less likely due to tb. So you can wait for AKT. And intensive phase usually given for 3 months no need to give further if you are responding to the treatment.