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Suggest Tests To Diagnose Abdominal TB
Question: how is abdominalTB diagnosed? what are all the required tests blood work and radiologing techniques to be done to identify. an ultrasound has revealed a hypoechoic track of 14 mm in anterior abdominal wal?whose the doctor for the treatment of abdominal tb if it is confirmed.pls guide in a detailedmanner,
Brief Answer:
Details below.
Detailed Answer:
Hello,
Welcome to HCM.
Abdominal tuberculosis can mimic a variety of other abdominal conditions/diseases
Sites of Involvement in Abdominal Tuberculosis
1. Gastrointestinal tract
2. Peritoneum, e.g. ascites
3. Lymph nodes
4. Solid organs, e.g. liver, spleen and pancreas
Gastrointestinal tuberculosis constitutes 70-78% cases of abdominal tuberculosis.
TB is often suspected if there are constitutional symptoms like evening rise of temperature, poor appetite, loss of weight, anemia etc in a person who is at risk. This is followed by clinical examination and investigations.
Blood tests may show anemia, high ESR or C reactive protein ( CRP).
PPD test ( Mantoux) may be positive.
Ultrasound , CT scan or MRI may show suggestive signs.
The highest yield is from a laproscopic examination or an ileo-colonoscopic examination in case of ileal tuberculosis.
In your case , the suspected lesion is on the anterior abdominal wall and it would easy to get a biopsy of the tissue. Histopathological examination of the tissue and a culture for AFB will show if it is tuberculosis.
If it is confirmed to be tuberculosis, a specialist in infectious diseases or in Internal Medicine would be the right person to treat you.
I shall be happy to answer any further query.
Take Care,
Dr Noble Zachariah
Details below.
Detailed Answer:
Hello,
Welcome to HCM.
Abdominal tuberculosis can mimic a variety of other abdominal conditions/diseases
Sites of Involvement in Abdominal Tuberculosis
1. Gastrointestinal tract
2. Peritoneum, e.g. ascites
3. Lymph nodes
4. Solid organs, e.g. liver, spleen and pancreas
Gastrointestinal tuberculosis constitutes 70-78% cases of abdominal tuberculosis.
TB is often suspected if there are constitutional symptoms like evening rise of temperature, poor appetite, loss of weight, anemia etc in a person who is at risk. This is followed by clinical examination and investigations.
Blood tests may show anemia, high ESR or C reactive protein ( CRP).
PPD test ( Mantoux) may be positive.
Ultrasound , CT scan or MRI may show suggestive signs.
The highest yield is from a laproscopic examination or an ileo-colonoscopic examination in case of ileal tuberculosis.
In your case , the suspected lesion is on the anterior abdominal wall and it would easy to get a biopsy of the tissue. Histopathological examination of the tissue and a culture for AFB will show if it is tuberculosis.
If it is confirmed to be tuberculosis, a specialist in infectious diseases or in Internal Medicine would be the right person to treat you.
I shall be happy to answer any further query.
Take Care,
Dr Noble Zachariah
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
thanks for the detailed reply.i m attaching all the details .pls guide further.also some doctors are suggesting for ultrasound guided biopsy and a theraputic starting treatment fot att,but i m reluctant without having any confirmation..is that procedure safe .for detection of abdominal tb or the problem related to my pain ct scan is better or mri post cesarean .is mantoux test results will ne relaible if i m on antibiotics..can u pls suggest some good infectious disease specialist in XXXXXXX right now i m taking zinase d for last 7 days amd cefi xl d for two days .the difference in both latest usg is after taking zinase d,but now i m also feeling pain in my left abdomen.is there something else that is not traceable.pls guide
Brief Answer:
Unlikely to be Tuberculosis.
Detailed Answer:
I have gone through all your reports, though they were difficult to read.
There is no clinical evidence suggesting tuberculosis.
The very fact that the lesion decreased in size on just anti inflammatory medicines without any anti TB medication goes against it being TB. The abdominal pain can be due to the diclofenac causing gastritis. Please stop the diclofenac and take a PPI like Omeprazole at a dose of 40mg per day. Can take seratiopeptidase alone.
There is no need of antibiotics unless there is fever, redness or swelling at the site. Just leave it alone for the time being and wait. The whole thing might get absorbed. If not, my suggestion would be to see a surgeon, to open up the lesion and it is not a major surgery as it is on the anterior wall, remove the tissue and get a histopathological examination.
You are not on any anti TB medication and mantoux test is not affected by cefixime.
I fully support your opinion that ATT should not be started without a tissue diagnosis of TB. I do not expect the tissue examination to show any evidence of TB.
Wish you a good day and good health.
Dr Noble Zachariah
Unlikely to be Tuberculosis.
Detailed Answer:
I have gone through all your reports, though they were difficult to read.
There is no clinical evidence suggesting tuberculosis.
The very fact that the lesion decreased in size on just anti inflammatory medicines without any anti TB medication goes against it being TB. The abdominal pain can be due to the diclofenac causing gastritis. Please stop the diclofenac and take a PPI like Omeprazole at a dose of 40mg per day. Can take seratiopeptidase alone.
There is no need of antibiotics unless there is fever, redness or swelling at the site. Just leave it alone for the time being and wait. The whole thing might get absorbed. If not, my suggestion would be to see a surgeon, to open up the lesion and it is not a major surgery as it is on the anterior wall, remove the tissue and get a histopathological examination.
You are not on any anti TB medication and mantoux test is not affected by cefixime.
I fully support your opinion that ATT should not be started without a tissue diagnosis of TB. I do not expect the tissue examination to show any evidence of TB.
Wish you a good day and good health.
Dr Noble Zachariah
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
thanku sir .the radilogist was very much sure of saying it to be tb..i m taking rablet d ..what formulation can i take for seratiopeptidase alone and for how long.there is redness amd warmth on my strech marks. how is tb or endiometeriosis of abdominal wall identified?and if it is the case whose the doctor that wil deal with this issue a general surgeon ,physician or a gynae ,infectious diaease specialist i m taking zinase d for 12 days for howmany days can it be taken.will ct scan help me in identifying my problem.. can this be coverted into cancer if i will wait and watch...can this be cellulitis ..as per my radilogist it is cellulitis tuberculosis .pls guide
Brief Answer:
Diagnosis has to be with tissue biopsy
Detailed Answer:
Zinase D contains diclofenac which can cause inflammation of stomach and intestines and can be stopped now.
Seratid 10 mg is plain seratiopeptidase and it help resolve the inflammation to some extent.
Ultrasound or CT scan is not the way to diagnose TB. A surgeon can take the biopsy of the lesion and if it is TB, you should see a specialist in Internal Medicine and take treatment. Biopsy would also help diagnosis if it is endometriosis.
There is no danger of the lesion becoming cancerous.
Hope I have answered your queries.
I shall be happy to answer if you have any further queries.
Wish you good health.
Diagnosis has to be with tissue biopsy
Detailed Answer:
Zinase D contains diclofenac which can cause inflammation of stomach and intestines and can be stopped now.
Seratid 10 mg is plain seratiopeptidase and it help resolve the inflammation to some extent.
Ultrasound or CT scan is not the way to diagnose TB. A surgeon can take the biopsy of the lesion and if it is TB, you should see a specialist in Internal Medicine and take treatment. Biopsy would also help diagnosis if it is endometriosis.
There is no danger of the lesion becoming cancerous.
Hope I have answered your queries.
I shall be happy to answer if you have any further queries.
Wish you good health.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
thanks doc.i went to my gynae today and she has now reffered me to physician.my physiacian is in the opinion of getting a ct scan of abdomen done and usg guided fnac.pls guide me of both in terms of safety and radiations involvement as per my health
for how long trial of att is given .my concern is that if i dont have that tb prob,i will still need to take so many med for at least 6 months,how to confirm whether i really reuired this as i have already been on so many amtibiotics for so long..will this att treatment will not make seroius side effects on my body.
i have got some blood work done tday.attaching all my reports.also i was on antibiotic for last 5 days,will these affect my blood work andESR.my chest x ray and tb gold test was negative too.
how is bacterial cellulitis identified.are there any test for thesame..its been three months of my surgery.will ct scan cause any harmful radiations that may hamper my healing futher.does it damage tissue.what does that hypoechoic track that is avasvular means..mri was repeated ii time already
IS There ny other test that i can get done to know about actual bactetial growth
PLS GUIDE
for how long trial of att is given .my concern is that if i dont have that tb prob,i will still need to take so many med for at least 6 months,how to confirm whether i really reuired this as i have already been on so many amtibiotics for so long..will this att treatment will not make seroius side effects on my body.
i have got some blood work done tday.attaching all my reports.also i was on antibiotic for last 5 days,will these affect my blood work andESR.my chest x ray and tb gold test was negative too.
how is bacterial cellulitis identified.are there any test for thesame..its been three months of my surgery.will ct scan cause any harmful radiations that may hamper my healing futher.does it damage tissue.what does that hypoechoic track that is avasvular means..mri was repeated ii time already
IS There ny other test that i can get done to know about actual bactetial growth
PLS GUIDE
Brief Answer:
There is nothing supporting TB in your latest results
Detailed Answer:
I am happy to note your latest results. There is nothing to suggest TB there. In fact the results are against TB. The WBC count shows more neutrophils than Lymphocytes which is usually the other way with TB. ESR is usually elevated much more in TB. There is no increase in Globulin which would occur if there is a chronic infection like TB. Chest Xray, TB Gold test are negative. Was a Mantoux test done?
FNAC is not sufficient to get sufficient tissue to confirm or exclude TB.
If you were my patient, I would ask the surgeon to take out sufficient tissue for a proper histopathological examination or remove that tract.
Also you do not have any symptoms typical of TB.
I don't think there is need for CT.
ATT can have dangerous side effects like hepatitis and I do not think you should take ATT without firm histological proof of TB.
Take Care
There is nothing supporting TB in your latest results
Detailed Answer:
I am happy to note your latest results. There is nothing to suggest TB there. In fact the results are against TB. The WBC count shows more neutrophils than Lymphocytes which is usually the other way with TB. ESR is usually elevated much more in TB. There is no increase in Globulin which would occur if there is a chronic infection like TB. Chest Xray, TB Gold test are negative. Was a Mantoux test done?
FNAC is not sufficient to get sufficient tissue to confirm or exclude TB.
If you were my patient, I would ask the surgeon to take out sufficient tissue for a proper histopathological examination or remove that tract.
Also you do not have any symptoms typical of TB.
I don't think there is need for CT.
ATT can have dangerous side effects like hepatitis and I do not think you should take ATT without firm histological proof of TB.
Take Care
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
thanks doc
1
i m suspecting it to be cellulitis..what are the test to confirm that so that i can take a proper medicine for proper infection.till now i feel hit and trial is going on.is there any blood test or something like to confirm staph infections in the body
2
my gynae has given me cefi xl d for 10 days along with zinase forte and rablet d. with su,mag ointment and luciara cream attaching the file of medicines that i have taken so far.is it safe to have so many antibiotica in a span of 3 months on and off..after that attached list i have taken a course of zanocin oz for 3 days and noq this cwfi xl d that contains cefixime and dicloxallin.does that have any significance with regard to my elevated lft values..does cefi xl causes itcing as i m allergic also.will that track further reduce feom this medicines because i consulted a surgeon also and he says this is part of post operative cesarean changes as i had my cesaran delivery 3 ,months back
3.can that tract convertvinto something cancerous or tumerous..sir i am afraid that it may lead to sepsis in me.pls guide
1
i m suspecting it to be cellulitis..what are the test to confirm that so that i can take a proper medicine for proper infection.till now i feel hit and trial is going on.is there any blood test or something like to confirm staph infections in the body
2
my gynae has given me cefi xl d for 10 days along with zinase forte and rablet d. with su,mag ointment and luciara cream attaching the file of medicines that i have taken so far.is it safe to have so many antibiotica in a span of 3 months on and off..after that attached list i have taken a course of zanocin oz for 3 days and noq this cwfi xl d that contains cefixime and dicloxallin.does that have any significance with regard to my elevated lft values..does cefi xl causes itcing as i m allergic also.will that track further reduce feom this medicines because i consulted a surgeon also and he says this is part of post operative cesarean changes as i had my cesaran delivery 3 ,months back
3.can that tract convertvinto something cancerous or tumerous..sir i am afraid that it may lead to sepsis in me.pls guide
Brief Answer:
No Staph infection. Will not become cancerous.
Detailed Answer:
There will be no cancerous change in the tract.
If the surgeon has examined you and feels, the tract is normal following a caesarian section and that there is no need for a biopsy, there is no need to investigate further.
Staph infection is not a silent infection. You will have symptoms like fever which you do not have.
If I were you, I would stop taking antibiotics and stop worrying about all unproven illnesses and get on with my life.
Have a good day and good health.
No Staph infection. Will not become cancerous.
Detailed Answer:
There will be no cancerous change in the tract.
If the surgeon has examined you and feels, the tract is normal following a caesarian section and that there is no need for a biopsy, there is no need to investigate further.
Staph infection is not a silent infection. You will have symptoms like fever which you do not have.
If I were you, I would stop taking antibiotics and stop worrying about all unproven illnesses and get on with my life.
Have a good day and good health.
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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