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Suffering from tubercular hilar adenopathy. On ATT drugs. Surgery needed?

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Practicing since : 1979
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Dear Doctor, 8 necrotic lymph nodes in the hilar area of 24 year old man.Diagnosed bi biopsy as tuberculosis. non HIV. the biggest node size is 32 mm below the vasculature. Pt receiving ATT 4 drus with 60,50,40,....weakly tapering. pt is getting 103 tempertaure 2 times a day. sugesst next drug. or any surgery required.

Posted Sun, 21 Apr 2013 in Lung and Chest disorders
Answered by Dr. Shashi Dangwal 3 hours later

From your description it is amply clear that the said patient is suffering from tubercular hilar adenopathy and has rightly been put on ATT. He has been put on steroid in view of paradoxical reaction but the patient does`nt seem to be responding. In view of this i suggest:

1. Let him be on steroids with slower tapering and patient will respond in due course of time if he is gaining weight and his cough is subsiding.

2. Repeat biopsy once more with MTB culture and ABST to rule out MDR-TB.

3. Ensure drug compliance on part of patient at all cost.

4. Look for any other cause for fever esp lymphoma should be ruled out.
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