Get your Health question answered in 3 easy steps
A Doctor will be with you shortly
Ask a Doctor Now
162 Doctors are Online

HIV positive patient. CT scan showed non-necrotic mediastinal lymphadenopathy. What are the chances of TB?

User rating for this question
Very Good
Answered by

Practicing since : 2003
Answered : 598 Questions
Hello Doctor,
     I’m a HIV positive patient with CD4 count 67 /μl and viral load 0000 copies/ml. i had occasional pain in the right side of my abdomen ( 3 times in last 6 months). I suffered herpes zoster a year ago.
I went to doctor to get ART . he wanted me to get a CT scan of chest done.

The CT scan showed that I have non-necrotic mediastinal lymphadenopathy ( report attached.)
I absolutely do not have cough , do not get fever , my weight is stable from last 3 years, no night chills, and I have healthy apatite.

My questions are
1)     Is there a possibility of TB ? what are the chances? How to test it further.
2)     If I have TB , can I take ART and medicine for TB together.?

I’ve appointment with doctor tomorrow. However your opinion will be really helpful to me.

Thanks in advance.
Posted Tue, 24 Jul 2012 in Lung and Chest disorders
Answered by Dr. Gyanshankar Mishra 14 hours later
Thanks for posting the query on XXXXXXX
After going through your query, I would like to comment the following:

1. Considering your HIV status and a low CD4 count, the presence of mediastinal lymphadenopathy points towards a very probable cause of tuberculosis as the etiological cause of mediastinal adenopathy.

2. Supportive investigations are: Ultrasonography of the abdomen, Mantoux test, Clinical examination for other sites of lymphadenopathy (If found any then FNAC from the lesion).

3. Considering your low cd4 count art and tb medications can be started simultaneously.

4.Also you need PCP and MAC prophylaxis (With septran and axithromycin respectively) at your CD4 count. Please discuss this issue with your doctor.

I hope I have answered your query. I will be glad to answer follow up queries if any.
Please accept my answer if you have no follow up queries.


Dr. Gyanshankar Mishra
Above answer was peer-reviewed by
Share on Facebook
Share on Twitter
Share on Google+
Question is related to
Diseases and Conditions
Lab Tests

The user accepted the expert's answer

Ask a Pulmonologist

© Ebix, Inc. All Rights Reserved.
All the information, content and live chat provided on the site is intended to be for informational purposes only, and not a substitute for professional or medical advice. You should always speak with your doctor before you follow anything that you read on this website. Any health question asked on this site will be visible to the people who browse this site. Hence, the user assumes the responsibility not to divulge any personally identifiable information in the question. Use of this site is subject to our Terms & Conditions
Already Rated.
Your rating:

Ask a Doctor