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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest treatment for recurrent fever and positive mantoux test result

Answered by
Dr.
Dr. Pradeep Kumar

Pediatrician, Cardiology

Practicing since :2006

Answered : 1975 Questions

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Posted on Tue, 16 Feb 2016 in Child Health
Question: My son age 2yr test of mountux 6 month ago is possitive and complete by 6 month course by macox tab docters says stop the akt but after blood tested by patients result esr-51 and crp-49 why region son for fever comes back 2 month daily treat fever medicine antibiotic but stop fever and again comes fever 4 to 5 days after please advise me
doctor
Answered by Dr. Pradeep Kumar 1 hour later
Brief Answer:
Mantoux test is not confirmatory for TB,Further investigation needed

Detailed Answer:
Hello

Thanks for the query

I can understand your concern.First of all I would like to know the detail history like
Whether there was any history of fever,persistent cough 6 months back?
Was there any history of poor appetite and weight loss?
Was there any family history of TB or any significant contact history?
Why doctor suggested you mantoux test?
Any other investigation done at that time?

Mantoux test is suggestive of tuberculosis infection but not confirmatory.There must be some other suggestive features to start treatment.
Again the raised CRP and ESR can be due to any inflammation/infection.
I would like to know the detail of antibiotic treatment and other investigations like Complete blood count,widal (for typhoid) chest Xray if done earlier.Also let me know if there are other symptoms apart from fever.
I would like to get a blood culture done.
Further treatment would depend on the basis of investigations and type of antibiotics used.

Please get back with the details so that I better able to help you out.

Regards




Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Pradeep Kumar 20 hours later
Hi, I have provided some attachments. Please review them.
doctor
Answered by Dr. Pradeep Kumar 1 hour later
Brief Answer:
Further investigations are needed

Detailed Answer:
Thanks for follow up

I have seen the reports.The previous reports show that the chest xray had features of pneumonia with positive mantoux,raised ESR and CRP.All these investigations suggest the diagnosis of pulmonary tuberculosis.The treatment of pulmonary tuberculosis is antitubercular medication for 6 months.As per your history the child has recieved the treatment for 6 months.
Now again the child has same symptoms and chest Xray shows the persistence of patch in lung.
Now the current illness can be due to the persistence of previous tubercular illness or due to a new infection.
Here I would like to investigate(like blood culture,widal,typhidot,malaria or other infective illnesses) the child to rule out any current illness and also to get a CECT chest done to see the nature of pneumonia or other suggestive features of TB like necrotic lymph nodes if any.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Pradeep Kumar 56 minutes later
Thanks sir
Please I talk in hindi sir
doctor
Answered by Dr. Pradeep Kumar 1 hour later
Brief Answer:
You may write in hindi also

Detailed Answer:
Hello

No problem sir.You may write in hindi.I shall be glad to help you out.

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