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Having severe headache and eye problem. Had kidney transplant. What is the cure?

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General & Family Physician
Practicing since : 2009
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my mother who is 62 years had her kidney transplant done 2 years back and is still having her medicines for post renial transplant patient. however recent ly she has been complaining of severe headache and eye problem until one day she has become very weak and could not recogize even us , we thought she had low sodium and got treated for a week which saw a somewhat improvement where once in a while she would lost her sense of recognation. when we took MRI te doctor said she had Brain TB and the cause of all this weakness and memory loss. kindly tell me whether its curable and what medicines should she have as she's already having medicines for her post renial trasplant for the past 2 years and to add with it she is a diabetic as well as bp patient. what should be her diet and how to be treated both in hospital as well as a home. ..the MRI Report say this: " Multiple conglomerated ring enhancng lesion in d frontal lobes with perifocal edema. likely to be tuberculomas. Diffuse periventricular demyelinations. Leukoencephalopat hy with cerebal atrophy ". What should be the next step to confirm that my mother has brain TB and is it sufficent to prove such disease by the above mRI report and if so whats the next treatment/steps. thank you
Posted Tue, 3 Dec 2013 in Brain and Spine
Answered by Dr. Shoaib Khan 1 hour later
Brief Answer: Mantoux test; protein rich diet, treatable Detailed Answer: Hello sir/madam and welcome. Thank you for writing to us. Unfortunately, I am very sorry to say but based on the provided MRI report, it does seem like tuberculosis of the brain is the most likely diagnosis, but you could further confirm the presence of tuberculosis with the help of a simple skin test using the PPD tuberculin, this is called the Mantoux test. But I should also advise you that this test can sometimes report a wrong result. TB of the brain (meningitis), if suspected should immediately be treated, without further ado, as it can lead to serious complications, which is why I would advise you not to delay by further testing right now. Many countries have various programs and regimens to tackle TB, and in India there are DOTS (), which provide free treatment and monitor the administration of medication themselves (which is very important in achieving good results). Please inquire about the nearest DOTS program clinic in your region and get your mother enrolled. Yes sir/madam, of course it is curable. But, TB is a very strong and resistant infection, which is why your mother will have to be treated without any mistakes, without missing of any medications, and so on. Treatment for all types and forms of TB are with anti-tubercular medication. Of course, your mother's history is important, but in my opinion, we can still go ahead with the first-line of anti-tubercular medication to achieve good results. First-line anti-tubercular medications include: rifampin, pyrazinamide, ethambutol and isoniazid. These will be administered by the doctor in the DOTS program, or even at any other medical institution available. They are available in the form of tablets, but it is best you make sure the doses are not skipped at all. TB results in weight loss and protein loss. So a protein rich diet will be required, you can consult her treating doctor and initiate protein powders and other food that is rich in protein to prevent excessive weight loss. I hope you found my response both helpful and informative. Please feel free to write back to me for any further clarifications or information. I would be more than happy to help. I shall remember your mother in my prayers, and wish her nothing but the best with a speedy recovery. God bless.
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Follow-up: Having severe headache and eye problem. Had kidney transplant. What is the cure? 15 hours later
Dear Doctor, thanks for your valuable information. my mother treatment has started last night and she is under ICU care as her state is very fragile however we have not done the PPD tuberculin as you suggested as the doctor is certain that she has brain tb. what about exposure to her grandchildren? do we need to isolate her during her treatment and how long is she needed to be hospitalized and whether such medications can be taken at home. how long will it take her to respond to her medications. how should we keep her under home care and its environment. thank you, XXXXX
Answered by Dr. Shoaib Khan 7 minutes later
Brief Answer: Keep hospitalized, responae cannot predict Detailed Answer: Hello XXXXX and welcone. Yes, as I had informed earlier, we need not re-test to confirm the diagnosis, as in TB meningitis cases we initiate treatment immediately. The risk for exposure is low as it is not considered an open case, but it is best to keep her grand-children away till the doctor feels it best and safe. For the time being, please let her remain hospitalized Lun, as brain TB can at times develop serious complications, and at home, these complications can go un-noticed. It is best to keep her there till she is better. As for the time taken to recover, this is a question no one can answer as different individuals respond in different ways. In most cases, response is seen within a few weeks if properly monitored and supervised by a doctor, but at times patients do not respond to the first-line of medications, which then requires the initiation of second-line of anti-tubercular medication. Individual response is what decides the duration that an individual would take to recover, so this question will unfortunately remain unanswered fora while. I hope I have succeeded in helping clear your queries. Please feel free to keep writing to me for any further clarifications and information. I am always here to help. Best wishes.
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