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TB treatment. Report said Mx strongly positive. Lost weight, ESR dropped. Best way to confirm lymphadenopathy is bronchosocpy or thoroscopy?

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Hi Doctor, I am 36 year old stay at Pune weight 85 kg, my esr earlier was 39.i am going through TB treatment for last four weeks, as for report is concerned the Mx was strongly positive whereas igm and sputum were negative, my x-ray and CT chest showed lymphadenopathy,also went through bronchoscopy at Artemis gurgaon the TBNA showed epithelioid and multinucleate giant cells, consistent with TB ,was the note written by doctor, who did bronchoscopy, he ask me to consult my physician after confirming this. So now treatment is i.e. Rcinex 600mg, Combutol 1.2gm, Pyzina 1.75gm,Benadone 20mg. I have lost some weight around 8-10 kg since last two months, and even after 4 weeks medicine coughing is still persistent though the frequency has come down but the bout happens in same intensity.Also esr has dropped to 10 now, and mild monocytosis seen in blood hemogram. My physician at pune says I have to take medicine for 3 months if no sign of improvement then ultra sound guided thoroscopy to find more on this. So my question if I am on right treatment or not, also why still not much sign of improvement in coughing though I am taking cough medicine Benz pearls(3 times too for coughing as prescribed by doc) also what is the best way to confirm the lymphadenopathy(lymph node tb) bronchosocpy or thoroscopy? Also I had pulmonary TB in 2002 confirmed through FNAC got treated for that 18 month, but now after almost ten year again infected by same disease, why any idea its recurring in my case? moreover is there any side effect medicine as my left eye has swollen a bit and unable to close it properly,doctor suspected bells palsy first but after brain mri it seem no lesion, seen please advise and help me in this by reply to my question..

Thanks and Kind Regards, XXXXXXX XXXXXXX
Posted Wed, 4 Jul 2012 in Lung and Chest disorders
Answered by Dr. Jasvinder Singh 3 hours later
Thanks for posting your query.

I do understand that there is little improvement in the cough which you are having. It is likely due to the involvement of the pleura or the irritation of the inner lining of the bronchi. The persistence of cough doesn’t mean that the disease is not healing.

The continuous fall in ESR in the absence of fever are good signs and depict recovery from the illness. I will suggest using some cough suppressants and doing steam inhalation at bedtime for two weeks.

Thoracoscopy is more invasive procedure than bronchoscopy. Thus bronchoscopy is preferred over thoracoscopy wherever possible.

In Bell’s palsy, the MRI may be normal. However the swelling of the eye doesn’t mean that you are suffering from Bell’s palsy. You should consult a neurologist or an ophthalmologist to confirm Bell’s palsy by means of clinical examination.

Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us.

Please accept my answer in case you have no follow up query.

Wishing you good health.


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