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Chronic cough and characteristics of TB - Online Doctor Chats

Date : 13-Jan-2012
User rating for this question
Excellent Posted in: Lung and Chest disorders
Answered by

General & Family Physician
Practicing since : 2004
Answered : 40 Questions
Doctor :   HI
Doctor :   How can I help yu
User :   hi
User :   i just happened to get this link and i thought why not try
User :   matter of fact, i do have a medical issue with my wife
User :   she is suffering from a chronic cough for the last 6 months now
Doctor :   ok
User :   initially it was nonproductive, started with itchy throat, more in the evenings and when she lied down.....
User :   now minimally productive, clear to light greenish sputum,
User :   as per the advice of qualified physician, did tsh, which was normal
User :   chest x-ray showed pneumonitis at the right lower base
User :   was started on ciprofloxaxin + ornidazole (5 days) and rupatidine, with initial relief, but then the cough started again
Doctor :   For Administrative and health purposes, Please provide these details -Age: Gender: Occupation: Location: Marital Status: Dependents: Yes/ No.
User :   ok sure
User :   Age: 32 Sex: Female Occupation: xxxx Location: xxxx, West Bengal Marital Status: Married Dependents: No
Doctor :   So what is the doctor saying now
User :   yes, the second dr. wanted some screening tests.....Mantoux, AFB, sputum c&s, and routine blood TC, DC, ESR, Hb,
Doctor :   yes
User :   he wants to rule out TB primarily.....
Doctor :   i too wnted the same
User :   now my query is, if Mantoux came as negative, then what could it be?
Doctor :   if the doctor still suspects the TB by clinical then the sputum analysis the anser
User :   ok, if sputum comes as negative for TB, then what r the possibilities for a diagnosis
Doctor :   Mycoplasma, Chlamydia and other rare diseases are to be thought of
User : more query regarding TB
Doctor :   k
User :   since i have been observing the sputum (very little productive) as clear to light green, not blood tinged, can it still be a TB?
Doctor :   Tb has many charecteristics
User :   means, i wud like to know whether TB necessarily produces the blood tinged sputum or not
Doctor :   one cannot say
Doctor :   thouth the sputum is white and non bloody
Doctor :   doesnt relate
Doctor :   since TB is rampant in this part of the world
Doctor :   the chronic cough should always rule tht out
User :   ok...
User :   now, since u r not in a position to see the chest x-ray urself, which reported as pneumonitis, how does it correlate with TB?
Doctor :   Please confirm your details
Doctor :   YYYY@YYYY
Mobile : 0000
User :   yes right
Doctor :   TB pneumonitis
User :   can both exist simultaneously?
Doctor :   it is the initialy stage of inflammation
Doctor :   yes
Doctor :   TB is one cause of pneumonitis
Doctor :   thought he lower lobe is un usual
Doctor :   initially
User :   oh
User :   now suppose my worst fear comes true, being diagnosed with TB.....then what sort of anticox treatment is going to be? any rough idea
Doctor :   first you will be put on 4 anti tb drugs'
Doctor :   for 2 months
Doctor :   then on 2 drigs for 6 months
Doctor :   this has to be taken regularly without fail
Doctor :   for the prescribed time period
User :   ok
Doctor :   else you may have to continue the whole thing again
Doctor :   thats the important part, not to discontinue
User :   then what r chances of being contagious?
Doctor :   or else it may never be cured
Doctor :   it will be contagious for the first month
User :   we r a husband wife couple, no kids yet, and living with my elderly mother
Doctor :   then onwards
Doctor :   its not
Doctor :   ok
Doctor :   also you should follow a high protein diet
User :   since one cannot really exactly pinpoint the onset of disease (supposed diagnosis of TB), then am I at risk too?
Doctor :   but first you should confirm if you have tb or not
Doctor :   for what?
User :   for getting TB myself
Doctor :   you need to consult a pulmonologist
Doctor :   ok
Doctor :   and show the xray
Doctor :   alo sputum exam helps
User :   ok...but first we have to confirm the diagnosis of TB, PPD has been placed today in the morning......
Doctor :   ok
User :   or u suggest we consult pulm straightaway?
Doctor :   we just have to wait for the reaction
Doctor :   you can consult a pulmonologist
Doctor :   as any respiratory infection can be treated adequately
Doctor :   by them
User :   sir, can u tell me one more aspect.....
Doctor :   ok
User :   the doc has prescribed empirically amoxicillin + clavulanate combo antibiotic, to start only after giving sample for sputum c and s,
User :   can i hold on the antibiotic until the 3 days for PPD results?
Doctor :   No
Doctor :   continue
Doctor :   the empirically treatment is
Doctor :   meant to control the infection before the sensitivity is know
Doctor :   known
Doctor :   that is the meaning of it
User :   see, the reason why i ask this is, if in the worst case it does turn out to be TB, then that antibiotic is useless isnt it
Doctor :   Never think that way
Doctor :   The empirical treatment is based onthe clinical scenario and teh local circum and the doctor's exp
User :   ok....
Doctor :   so the medical lit always insist on the empirical
Doctor :   before the actual culture result
User :   ok sure....
Doctor :   If the doctor asks you to take the tx take it
Doctor :   if he says to withhold then you have to
User :   he said, after we give her sputum for culture, we start her on it
Doctor :   ok follow his words
User :   she did produce a minimal amount of sputum, and we submitted for c/s, and was in a dilemma of sorts.....
User :   now i feel a little confident talking to u, and will surely follow his Rx
Doctor :   yu may supplement her with DGL LICORICE for brochitis it is a herbal supplement
Doctor :   it is approved for bronchitis
User : it a brand name?
Doctor :   they are the tablets
Doctor :   of GNC pharnma
Doctor :   For Details Visit and Buy the product at www.xxxx.xxxx
User :   ok i ll surely check it up
Doctor :   ask your doctor
Doctor :   because it may interact with the medicine he amy give
Doctor :   so check it
Doctor :   Pl; fill the feedback form
Doctor :   ar you done
Doctor :   bye
Doctor :   get back to us
Doctor :   with the results
Doctor :   and follow up with us
Doctor :   ok
Doctor :   bye
User :   yes sir i m done
User :   yes sure
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