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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest treatment for tubercular meningitis

Suggest ideal treatment for TB meningitis Hi respected physicians My wife is suffering from TB meningitis from 7.2.2017. Her age 33. She was admitted in hospital for 14 days. Her csf showed 95 % proteins and 100 percent lymphocytes. Now she s taking TB medicines Myrine P Forte containg isoniazid rimpaficin and ethambutal etc plus steroids. Currently she feels noise in head, headache, vomiting and visual turbidity while neck stiffness has shown reduction in two weeks treatment. But the main thing i want to bring in to notice is that temperature of 101 0r102 appears after 2-3 days gap and 100 temp is more often.We did LFT test in that SGPT is higher than 200 and her bilirubin level is slightly above 2. One doctor told me to stop medicine of TB for obe week and when LFTs normalise then start again. But i worry that stopping ATB in tubercular meningites would be dangerous. Kindly suggest me her situation about 1 fever 2 ATB continuty gap 3 abnormal sgpt I ll be highly thankful. Saify Email YYYY@YYYY
Tue, 27 Nov 2018
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Internal Medicine Specialist 's  Response
Hello,

She may be suffering from drug-induced hepatitis so she has to discontinue antitubercular medication otherwise chances to develop liver failure.

So Stop isoniazid, pyrazinamide and rifampicin. She may continue streptomycin and ethambutol etc.

Please follow up with regular checkups for serum bilirubin and SGOT, SGPT level.

Please consult your physician he will examine and treat you accordingly.

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Penchila Prasad Kandikattu,
Internal Medicine Specialist
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