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What Does A Positive TB Report Indicate?

Posted on Thu, 9 Apr 2015

Question: hii.my mom 48 years of age has been diagnosed TB positive in TB quarantiine test but negative in montoux n M.tb Pcr from the tissue. Her biopsy reports shows chronic ulcerative ileitis n non specific inflammation in her small intestine. her CT scan reports shows there is a narrowing of the small intestine near the ileo cecal junction and there is a small hernia in the abdominal wall.all her blood tests are normal except for
a) high CRP
b) low haemoglobin
c) serum albumin is low
d) serum chromogranin A is high.
e) low B12 and Vit D3 levels.
Doctor advised her following medicine and during first week she was ok but after that she feels quite uneasy after taking the medicines,she suffers from vomiting,loose motion,abdomen pain,fever, and swelling/gas in stomach. the medicines are; Tab AKT 4, tab Benadon 40mb twice daily,syrp XXXXXXX twice daily,tab shelcal ct 500 mg twice daily, XXXXXXX trazodac fast.
please suggest me what to do now as the doctor is not responding now and my mom is not in a condition to travel so long distance.

Answered by Dr. Divakara (12 hours later)

Brief Answer:
Stop AKT4 for a while.

Detailed Answer:
HI

Greeting from Dr. Divakara.P
First of all thanks for choosing Healthcaremagic for posting your query.

Well the diagnosis and treatment started is fine but she is not tolerating it. AKT4 is very known to cause gastric problems like Vomiting , loose motions , gas in stomach.

More over she has ileitis which means there is inflammation in her gut which makes it more difficulty to tolerate the AKT4. So my advise is stop the AKT4 ( also Shelcal ) medicines for 3-4 days . Let her fever , loose motions vomiting settle.

Once she feels comfortable start AKT4 in half the recommended dose , give for for 7-10 days and once she starts tolerating it better you can give AKT4 in full dose .

Her Serum Chromogranin is Elevated which may point towards a Diagnosis of IBD. For more confirmation of the diagnosis I recommend you get her a test called Stool for Calprotectin levels and revert back to me .

Also Stop Trazodac fast as it can cause Vomiting. Get a prescription of Rabeprezole and Emeset for her Gastritis and Vomiting and Dolo for her fever.

Hope this information was useful to you.
Any clarifications feel free to ask .

Regards.

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

Follow up: Dr. Divakara (3 hours later)

during the first week of medications she was fyn but after that the problem started. we stoped her medication for three days and she responded well and was fyn but when the day she started with the medicines same problem started,she even could not stand up. so we have stoped the medication. Even the doctor asked for a LFT test 1 week aftr the medication started n the test showed normal result.but just aftr the test she started getting the sideeffects.

Answered by Dr. Divakara (2 hours later)

Brief Answer:
Follow same advise.

Detailed Answer:
HI

That's what she is finding it difficult to tolerate medicine but she has to take those some day.

My advise remains the same . Stop the AKT4 medicines for 3-4 days, Once she feels comfortable start AKT4 in half the recommended dose , give for for 7-10 days and once she starts tolerating it better you can give AKT4 in full dose .

Also get the prescription of Rabeprezole and Emeset and let her use it .

If she vomits again then she has to be hospitalised and given Rabeprezole and emeset Injections and then initiate AKT4 in half dose .

Revert back with the Stool for Calprotectin levels test report.

Regards.

Note: For further follow up on digestive issues share your reports here and Click here.

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