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What Causes Vomiting And Fever With Negative CT And MRI Tests?
Question: dear dr sir
At first I thank you for the service.
I would like to clarify some doubts regarding my close and intimate friend's disease.
First she felt fever and had medicine from family dr. And that lasts for fivedays and she get tired and she started vomiting too. Then she is hospitalised. She is now in europe and hospitalised there. Seventh day they said that they suspect some microbacterial/viral infection and also suspected tuberculosis meningitis and started the antibiotic 4 tablets plus one injection. But in the CT,MRI, and BLOODTEST it all negative and no problem with that.
They took CSF for testing first day.
Sixth day of admission she got some diarrhea like and they told it is because of medicine and given another medicine for stopping that.
And today(7th) they want to take CSF again for some other test saying that it is for testing wbc count.
she is discharged on 9th august and she is home now.
The dr told to come over for mri on 22nd and advised to consult on 25th august. And also asked to took blood test too which she took on 12th.
Dr, pl. tell me what is her actual disease? Is that tb meningitis? What we have to do now? Is she can come here and take medicine? Is this contagious?
Whats the actuals? As she is far away we cant enquire more there. The report is translated and attached herewith for your reference.
pls reply me urgently
thanks & regards
XXXXXXX
At first I thank you for the service.
I would like to clarify some doubts regarding my close and intimate friend's disease.
First she felt fever and had medicine from family dr. And that lasts for fivedays and she get tired and she started vomiting too. Then she is hospitalised. She is now in europe and hospitalised there. Seventh day they said that they suspect some microbacterial/viral infection and also suspected tuberculosis meningitis and started the antibiotic 4 tablets plus one injection. But in the CT,MRI, and BLOODTEST it all negative and no problem with that.
They took CSF for testing first day.
Sixth day of admission she got some diarrhea like and they told it is because of medicine and given another medicine for stopping that.
And today(7th) they want to take CSF again for some other test saying that it is for testing wbc count.
she is discharged on 9th august and she is home now.
The dr told to come over for mri on 22nd and advised to consult on 25th august. And also asked to took blood test too which she took on 12th.
Dr, pl. tell me what is her actual disease? Is that tb meningitis? What we have to do now? Is she can come here and take medicine? Is this contagious?
Whats the actuals? As she is far away we cant enquire more there. The report is translated and attached herewith for your reference.
pls reply me urgently
thanks & regards
XXXXXXX
Brief Answer:
Explaining the condition
Detailed Answer:
hello Mr XXXXXXX XXXXXXX XXXXXXX
First, please realx. If the doctor has discharged her, she must be better. And you need only continue the medicines and do the tests. The tests are done basically to evaluate her condition as of date in comparison to the previous status. Thats routine and normal
I have read the papers attached in the query.
I have seen the report of csf that they have attached, and it definitely seems to be suggestive of meningitis, with possible tubercular cause (etiology).
i am not sure from this summary however as to whats the current treatment status.
Therefore I cannot comment on what they are thinking. But I am certain that they need the repeat tests to make sure that the things are improving.
She can definitely take medicines, however her treating doctor is a better judge of that as the doctor knows the exact situation. The treatment of TB is available quite vastly (I dont know where you mean wehn you say "here"). And yes TB is communicable, but not necessarily.
Please feel free to ask a follow up related query, or if you feel I have not answered any particular concern- kindly let me know the exact thing you wish to know if thats the situation.
Best of luck
Dr Mittal
Explaining the condition
Detailed Answer:
hello Mr XXXXXXX XXXXXXX XXXXXXX
First, please realx. If the doctor has discharged her, she must be better. And you need only continue the medicines and do the tests. The tests are done basically to evaluate her condition as of date in comparison to the previous status. Thats routine and normal
I have read the papers attached in the query.
I have seen the report of csf that they have attached, and it definitely seems to be suggestive of meningitis, with possible tubercular cause (etiology).
i am not sure from this summary however as to whats the current treatment status.
Therefore I cannot comment on what they are thinking. But I am certain that they need the repeat tests to make sure that the things are improving.
She can definitely take medicines, however her treating doctor is a better judge of that as the doctor knows the exact situation. The treatment of TB is available quite vastly (I dont know where you mean wehn you say "here"). And yes TB is communicable, but not necessarily.
Please feel free to ask a follow up related query, or if you feel I have not answered any particular concern- kindly let me know the exact thing you wish to know if thats the situation.
Best of luck
Dr Mittal
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
dear dr sir
thank you for the reply. I have sent an immediate reply yesterday but not delivered that i think.
1. Current treatment is:THREE MEDICINES:: DELTACORTENE-HALF AT 7.45 hrs; LEVOFLOXACINA 1 AT 8.00 HRS AND 1 AT 20.00HRS, ; RIMSTAR 4 CAPSULE AT 16.00 hrs---TOTAL 6AND HALF TABLETS DAILY.( in the summary itself this is mentioned)—Pl. let me know whether the dr will reduce this medicines on 22 nd which she has checkup? And IF so how many days she has to take these medicines? If on 22 nd the result all normal, then what will be next?
And i think the deltacortene tab is steroid. So Any problem of side effects by this medicine and all that medicines?
2. “tb IS communicable, but not necessarily”—what it mean dr? I want here to be here in XXXXXXX with me as she is not well. So if anything precaution to take in household? pl. let me know
3. Whether she can come XXXXXXX with that medicine and have it from staying with me itself.
4.And also her disease is suspected tbm. So not yet confirmed. am I right dr? If so why ?
Expecting your valuable reply at the earliest.
thanks & regards
XXXXXX
0000
YYYY@YYYY
thank you for the reply. I have sent an immediate reply yesterday but not delivered that i think.
1. Current treatment is:THREE MEDICINES:: DELTACORTENE-HALF AT 7.45 hrs; LEVOFLOXACINA 1 AT 8.00 HRS AND 1 AT 20.00HRS, ; RIMSTAR 4 CAPSULE AT 16.00 hrs---TOTAL 6AND HALF TABLETS DAILY.( in the summary itself this is mentioned)—Pl. let me know whether the dr will reduce this medicines on 22 nd which she has checkup? And IF so how many days she has to take these medicines? If on 22 nd the result all normal, then what will be next?
And i think the deltacortene tab is steroid. So Any problem of side effects by this medicine and all that medicines?
2. “tb IS communicable, but not necessarily”—what it mean dr? I want here to be here in XXXXXXX with me as she is not well. So if anything precaution to take in household? pl. let me know
3. Whether she can come XXXXXXX with that medicine and have it from staying with me itself.
4.And also her disease is suspected tbm. So not yet confirmed. am I right dr? If so why ?
Expecting your valuable reply at the earliest.
thanks & regards
XXXXXX
0000
YYYY@YYYY
Brief Answer:
Specific answers
Detailed Answer:
Hi
I have read your further queries.
I will answer these one by one specifically.
The medicines are running for TB- Levofloxacin and Rimstar. The steroid is given as a part of treatment schedule. It is a part of the course. And as of now, the benefits are greater than the side effects. The medicines are expected to continue as such.
In XXXXXXX we give a 4 drug treatment for TB. Not so in UK. The reason is that TB prevalance is high in XXXXXXX So your doctor in XXXXXXX may change the treatment.
The fact also is that TB affects all parts of the body. If it affects a part from where the bacteria can come out, like chest TB, it can spread. From the details, I am not sure if her TB is limited to the brain or spread in the lung also.
Whether she can come to XXXXXXX can only be decided by her treating doctor. Only he can decide if she is fit enough to make the journey. But yes we can treat her in XXXXXXX if thats what you mean.
Her disease is suspected TBM. This concept is a bit difficult to explain. I will try me best. Lets just say that there are 2 parts of csf investigations of TB. First part is quite positively positive for TB, the second part is not. The second part is supposed to show the TB bacteria. That is negative. So we cannot say confirmed that TB is there. But first part definitely suggests TB- hence suspected.
I hope that answers your repeat queries
Dr Mittal
Specific answers
Detailed Answer:
Hi
I have read your further queries.
I will answer these one by one specifically.
The medicines are running for TB- Levofloxacin and Rimstar. The steroid is given as a part of treatment schedule. It is a part of the course. And as of now, the benefits are greater than the side effects. The medicines are expected to continue as such.
In XXXXXXX we give a 4 drug treatment for TB. Not so in UK. The reason is that TB prevalance is high in XXXXXXX So your doctor in XXXXXXX may change the treatment.
The fact also is that TB affects all parts of the body. If it affects a part from where the bacteria can come out, like chest TB, it can spread. From the details, I am not sure if her TB is limited to the brain or spread in the lung also.
Whether she can come to XXXXXXX can only be decided by her treating doctor. Only he can decide if she is fit enough to make the journey. But yes we can treat her in XXXXXXX if thats what you mean.
Her disease is suspected TBM. This concept is a bit difficult to explain. I will try me best. Lets just say that there are 2 parts of csf investigations of TB. First part is quite positively positive for TB, the second part is not. The second part is supposed to show the TB bacteria. That is negative. So we cannot say confirmed that TB is there. But first part definitely suggests TB- hence suspected.
I hope that answers your repeat queries
Dr Mittal
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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