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Diagnosed with bone TB. Elisa kochs tested negative. What is the best method and duration of medication?

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Internal Medicine Specialist
Practicing since : 2001
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My sister has been diagnosed with bont TB. The test of CRP (turbimeditric) is 61.6 and the x XXXXXXX reports states:
para vertebral soft tissue swelling
moderate reduction in D11/12 disc space
moderate anterior wedging of D11
mild anterior wedging of D12
sclerosis of D11/12
mild gibbus deformity with end plate erosive change likely due to koch's infection
but the Elisa koch's test[IgG] shows Negative result with 182.5 and Elisa kochs [IgM] is also Negative with 0.76 value.
I just want to confirm is it still Bone TB when elisa koch's test has negative results and if yes what is the best method and duration of medication to be used and what does the patient do in case high pain. Due to High Pain she has also has been given Dexona injection apart from the medicines prescribed below for the last 10 days twice a day. The pain has susided a lot due to this injection does it needs to be continued. Please suggest accordingly the reports have been attached.
Posted Sat, 1 Sep 2012 in Bones, Muscles and Joints
Answered by Dr. Ram Choudhary 52 minutes later
Welcome to healthcare Magic!
The TB can be diagnosed with surety with local physical examination and imaging most specifically MRI Spine along with patent's history.
Elisa Koch's test is negative falsely in many cases.
Your doctor has sufficient reason to diagnose her as TB Spine.
Steroid is very important part of initial treatment of Spine and brain TB and it's dose may be need to be increased if needed, it acts to decrease the local inflammation and pain, it's dose would be tapered by your physician depending on response..
Your sister has got extensive tuberculosis, she is very lucky that she did not get permanent loss of power in lower limb.
She should take regular anti-TB medicines and should not bear weight, I would suggest a Spine support to be used all the time when she is upright.
She may develop a paraplegia and may need surgery for decompression and XXXXXXX fixation anytime if starts having increasing weakness.
Ensure a regular follow up to your physician because she will need review imaging and prolonged treatment for 12-18 months.
I hope the advise will be helpful for you.
I wish her a good recovery.
Above answer was peer-reviewed by
Follow-up: Diagnosed with bone TB. Elisa kochs tested negative. What is the best method and duration of medication? 2 hours later
The quick response is highly appreciated but i came across few points that i could not undertand.
1. What did you mean by steroid is it same as as Dexona injection that i referred to in my previous question. The physican did not prescribe it but it was prescribed by another Doctor.
2.The Physician told us that her TB was in initital stage and medication was enough for the treat ment but you mentioned it as extensive tuberculosis. Is it a matter of concern and if so why
3.What do you mean by Spine Support. What are the best spine support available in the market can you please suggest.

Waiting for quick response.
Answered by Dr. Ram Choudhary 2 hours later

Welcome back to Healthcare Magic!

Dexona is dexamethasone and it is a steroid and is rightly prescribed to her, I would rather advise it thrice a day which is the standard dosing to start, later it is reduced.

The TB she is having has affected to vertebra sufficient to cause an unstable spine and paraplegia that is why I want a spine support to be used.

Please visit a Surgical items store or Physiotherapy equipment store, they have a wide belt with metal rods in it, called a Brace which can be worn on the torso to support the spine.
I hope that answers your doubts.
Above answer was peer-reviewed by
Follow-up: Diagnosed with bone TB. Elisa kochs tested negative. What is the best method and duration of medication? 7 hours later

Thanks for the quick response. Your answers have really helped to sort out the confusions we had. Just another query regarding the dose of Dexona.
She was given Dexona twice for 6 days from 1st August and that has been reduced to a single injection daily since then. Would you suggest to increase the dose of the same and if then how much and how should be gradually reduce it.
Secondly, she has been using an electronic warming belt twice which provides some relief, is it advisable or should it be avoided.

Answered by Dr. Ram Choudhary 9 hours later
Welcome back, I was out for some work.
Sorry for delay.
The higher dose of dexona is recommended in the initial phase of treatment.
Now she has already started it so let your clinician decide about reducing and tapering it.
You should avoid the warming belt, it can spread/aggravate the infection.
I hope I have answered your query.
Above answer was peer-reviewed by
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