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What Do The Following Test Reports Indicate?
Question: Hi Doctor,
I am speaking about my mother who is aged 54 years. Last XXXXXXX 2014 she was diagnosed with Extra-pulmonary TB due to enlargement of Left armpit lymphnodes. Her fever started from 12th May 2014. She was diagnosed on 23/6/2014. She was also complaining about severe headache. Tests were carried out and TB Meningitis was proved. She started with the first line of drugs consisting of
Isoniazid-300mg
Rifampicin-450mg
Pyrazinamide
Ethambuto-1000mg
She continued Ethambutol till November 2014 when suddenly she complained of blurriness and also Green Colour blindness(to slight extent) and was diagnosed Retrobulbar Neuritis. Ethambutol was discontinued at once followed by Isoniazid within one week. MRI was carried out which confirmed the same but of very low intensity.
The drugs she had and duration:-
1) Pyrazinamide:- 2 months
2) Ethambutol and Isoniazid:- 4.5 months
3) Streptomycin:- 60 days
4) Rifamcin:- 11 months
5) Ofloxacin:- 7 months
6) Levofloxacin:- 5 months.
Doctor has asked to stop all drugs at the moment.
Her Blood Test report:-
Basophil-4(Normal is said as 3 or below)
ESR-27(Normal 20 and below)
Lymphocyte:- 44%
WBC-6800(normal below 11000)
She has recovered almost 70% of her vision. But her vision is still not normal. Can you please tell how much time it will take?
She is a diabetic patient but it generally remains normal after taking drugs.
Thanks and Regards,
XXXX
I am speaking about my mother who is aged 54 years. Last XXXXXXX 2014 she was diagnosed with Extra-pulmonary TB due to enlargement of Left armpit lymphnodes. Her fever started from 12th May 2014. She was diagnosed on 23/6/2014. She was also complaining about severe headache. Tests were carried out and TB Meningitis was proved. She started with the first line of drugs consisting of
Isoniazid-300mg
Rifampicin-450mg
Pyrazinamide
Ethambuto-1000mg
She continued Ethambutol till November 2014 when suddenly she complained of blurriness and also Green Colour blindness(to slight extent) and was diagnosed Retrobulbar Neuritis. Ethambutol was discontinued at once followed by Isoniazid within one week. MRI was carried out which confirmed the same but of very low intensity.
The drugs she had and duration:-
1) Pyrazinamide:- 2 months
2) Ethambutol and Isoniazid:- 4.5 months
3) Streptomycin:- 60 days
4) Rifamcin:- 11 months
5) Ofloxacin:- 7 months
6) Levofloxacin:- 5 months.
Doctor has asked to stop all drugs at the moment.
Her Blood Test report:-
Basophil-4(Normal is said as 3 or below)
ESR-27(Normal 20 and below)
Lymphocyte:- 44%
WBC-6800(normal below 11000)
She has recovered almost 70% of her vision. But her vision is still not normal. Can you please tell how much time it will take?
She is a diabetic patient but it generally remains normal after taking drugs.
Thanks and Regards,
XXXX
Brief Answer:
May take upto one year
Detailed Answer:
Hi,
I hope you remember me. We had a good discussion on the issues pertaining to your mother.
Now, since all the medicines and particularly the main culprit Ethambutol has been stopped, so it is very likely that she would regain her full vision in 12 months to 3 years time. But this is possible only in the case, the damage is reversible.
Ethambutol optic neuropathy, in our follow-up study, is not always reversible, especially in the older population. However in most cases as we see in clinical practice and studies also claim that it is reversible.
She should go to regular follow up with an opthalmologist who would also determine any evidence of Diabetic retinopathy associated, that might be responsible along with this.
There is no special treatment is given to patients. The recovery is mostly spontaneous, however slow.
But you should also be mentally prepared, that a lot many people have permanent damage and the recovery is never completely achieved.
I hope it helps you.
If you have any further questions, please ask me.
May take upto one year
Detailed Answer:
Hi,
I hope you remember me. We had a good discussion on the issues pertaining to your mother.
Now, since all the medicines and particularly the main culprit Ethambutol has been stopped, so it is very likely that she would regain her full vision in 12 months to 3 years time. But this is possible only in the case, the damage is reversible.
Ethambutol optic neuropathy, in our follow-up study, is not always reversible, especially in the older population. However in most cases as we see in clinical practice and studies also claim that it is reversible.
She should go to regular follow up with an opthalmologist who would also determine any evidence of Diabetic retinopathy associated, that might be responsible along with this.
There is no special treatment is given to patients. The recovery is mostly spontaneous, however slow.
But you should also be mentally prepared, that a lot many people have permanent damage and the recovery is never completely achieved.
I hope it helps you.
If you have any further questions, please ask me.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi Doctor,
1) What is the age to call one 'older population' ?
2) Her diabetes is very much controlled
3) Please check the reports I have uploaded.
4) She is recovering but slowly. She cannot read newspapers and people quite far. Now she can read small prints but individually.
Thanks and regards,
XXXX
1) What is the age to call one 'older population' ?
2) Her diabetes is very much controlled
3) Please check the reports I have uploaded.
4) She is recovering but slowly. She cannot read newspapers and people quite far. Now she can read small prints but individually.
Thanks and regards,
XXXX
Brief Answer:
Have seen the reports
Detailed Answer:
Dear XXXX,
I have already seen the reports. In fact they explain a good prognosis.
Following are your answers:
1. Age of > 60 years.
2. A well controlled diabetes still requires a fundus examination for retinopathy.
3. I have seen the reports prior to answering you.
4. Hopefully, her vision would improve more. But i really can't commit the time and the extent.
If you have any further query, please ask me.
Have seen the reports
Detailed Answer:
Dear XXXX,
I have already seen the reports. In fact they explain a good prognosis.
Following are your answers:
1. Age of > 60 years.
2. A well controlled diabetes still requires a fundus examination for retinopathy.
3. I have seen the reports prior to answering you.
4. Hopefully, her vision would improve more. But i really can't commit the time and the extent.
If you have any further query, please ask me.
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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