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Suggest treatment for TB infections in lymph nodes

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Posted on Mon, 16 Jan 2017
Question: sir I am diagnosed with Tubular Lymphadenitis and going treatment with anti TB therapy with akurit 4 for first two months. I am attaching the xray report .now how can I know that my treatment is going on well or not. As I am taking the medicine empty stomach early morning and not taking even a glass of water of at least 2 hours after taking medicine. so please tell me how can I confirm that my treatment is going on well for my satisfaction. also attaching the x ray report of first week of my treatment.
doctor
Answered by Dr. Divakara (3 hours later)
Brief Answer:
Need information on the site of TB Lymphadenitis.

Detailed Answer:
HI

Thanks for posting your query.

First of all , let me explain you about TB Lymphadenitis. It means Tuberculosis of Lymph nodes . Now lymph nodes are present all over the body-- behind the head, under the cheeks/ jaw, in and around the neck , in the armpits , in the chest , in the abdomen or in the groins.

I have gone through your X ray report but it is not showing any signs of TB. But I need to know if any Chest X ray was done before starting Akurit.

Now you have been diagnosed as TB Lymphadenitis. I need to know which area Lymph nodes are infected with TB. Also let me know what symptoms you had when you were diagnosed as TB Lymphadenitis. So based on that information I can tell whether the treatment is going well or not .

Regards
Above answer was peer-reviewed by : Dr. Remy Koshy
doctor
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Follow up: Dr. Divakara (1 hour later)
sir attaching my FNAC report for clarification and as on date of starting the treatment I have no symptoms of cough or fever or weight loss any thing just found the swallow lymph node on the neck and followed as per the doctor instructions. The x ray was done after seven days of starting of my treatment.so please tell me as it is nearly two months of my treatment I am continuously taking the medicine whether my treatment is going on well or not.
doctor
Answered by Dr. Divakara (2 days later)
Brief Answer:
Lymph nodes should reduce in Size.

Detailed Answer:
HI

Thanks for the follow up.

So as per your reports you are having TB of Cervical ( Neck region ) . The symptoms you had before starting Akurit was Lymph node swelling on the neck. X ray was done to check if you had any Lung TB .

Now the response to treatment can be assessed by reduction in the size of Lymph nodes. This assessment can be made either by personal examination of the lymph nodes in the neck or by doing Ultrasound scan of the neck . If the medication is working well there should be reduction in the size of Lymph nodes.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Divakara (1 hour later)
sir thank you very much for your prompt response.can I use probiotic entergermino oral for before lunch and dinner continuously for six months .as entergermino is a not H1 drug so can it be discontinued any time.
doctor
Answered by Dr. Divakara (30 hours later)
Brief Answer:
Enterogermina can be taken for months

Detailed Answer:
HI

Yes it can be used . But i recommend to use only if you have abdominal discomfort or any loose motions .

But in case you want to take yes it can be taken for six months and can be discontinued any time.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Divakara (42 hours later)
sir is there any chance that I am suffering from MDR TB
doctor
Answered by Dr. Divakara (1 hour later)
Brief Answer:
Less likely.

Detailed Answer:
HI

See most of the time MDR TB is seen in patients who have been previously diagnosed as TB , advised treatment for 6-9 months but the patient defaults and doesn't complete full treatment.

If there is a good response to the normal TB medications then we don't suspect MDR TB. So if there is some ( need not be significant ) reduction in the size of Lymph nodes then there is extremely less chance of you having MDR-TB.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Divakara (22 hours later)
sir is there any chances of ESR test normal in completion of third month of treatment in tubular lymphadenitis
doctor
Answered by Dr. Divakara (1 hour later)
Brief Answer:
Yes

Detailed Answer:
Hi

Yes it can happen but , in case it is not normalised doesn't mean that treatment is not working. Just that ESR should not rise.

Regards
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Divakara (25 minutes later)
sir my swallow lymph nodes is reduced a much within this two months of treatment.so if at all I go for ESR test it has to come normal or it may come high .
doctor
Answered by Dr. Divakara (2 hours later)
Brief Answer:
May or may not be normal.

Detailed Answer:
Hi

It may or may not come to normal but it should be at least less than what it was before treatment.

But definitely it will not be high.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Divakara (15 hours later)
sir attaching my ESR report before starting of my treatment and now as in the photo attached my swallow lymph node was reduced so means my treatment is going well . can you explain????
doctor
Answered by Dr. Divakara (17 minutes later)
Brief Answer:
Lymph nodes are reducing

Detailed Answer:
Your Lymph nodes seems to have reduced , that's a good sign that medications are working.

Couldn't see any report of ESR.

Kindly re upload.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Divakara (12 minutes later)
sorry sir attaching the report
doctor
Answered by Dr. Divakara (19 hours later)
Brief Answer:
ESR isnormal.

Detailed Answer:
HI

Your ESR level is 3 . This is normal level of ESR. Now if this was your pretreatment ESR then we cannot use ESR to monitor the response of treatment as it is normal before treatment itself.

Sowe have to rely totally on the resolution of the size of Lymph nodes .

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Dr. Divakara

Internal Medicine Specialist

Practicing since :2006

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Suggest treatment for TB infections in lymph nodes

Brief Answer: Need information on the site of TB Lymphadenitis. Detailed Answer: HI Thanks for posting your query. First of all , let me explain you about TB Lymphadenitis. It means Tuberculosis of Lymph nodes . Now lymph nodes are present all over the body-- behind the head, under the cheeks/ jaw, in and around the neck , in the armpits , in the chest , in the abdomen or in the groins. I have gone through your X ray report but it is not showing any signs of TB. But I need to know if any Chest X ray was done before starting Akurit. Now you have been diagnosed as TB Lymphadenitis. I need to know which area Lymph nodes are infected with TB. Also let me know what symptoms you had when you were diagnosed as TB Lymphadenitis. So based on that information I can tell whether the treatment is going well or not . Regards