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Can Low Grade Fever Persistent For 2 Days Be Due To Pulmonary Tuberculosis ?

Posted on Sun, 15 Apr 2012

Question: My son, 42 yrs old, has a 20mm PPD test. He was diagnosed with pulmonary tuberculosis about 15 years ago and treated with combination of pills for PTB. He wants to know if he has the active type or the latent type and I know the it should be correlated with his chest xray and symptoms before you can say that it is active. He sought consultationbecause of almost 2days of low grade fever. Before the fever he had on and of cough and difficulty of breathing which he associated with his bronchial asthma. Anyway, his CXR showed lobar pneumonia . Ultrsound was done and it showed pleural effusion. So he was admitted and diagnosed as having lobar pneumonia with pleural effusion, L, and bronchial asthma. Some of his tests showed fibrosis of some parts of his right lung which I interpreted as scarring from previous TB. He is already out of the hospital but still with small amount of fluid. During one of his follow up check ups, my son asked his doctor why in the first place he has pleural infection. The doctor said it might be from TB. So he gave the combination of anti TB medication. My son had to go back and ask his doctor if it is contagious or not because my daughter and my son together weith their dog is in the same house. After the PPD test has been read as positive 20 mm just this afternoon, he wants to know right away if it is contagious. Before his hospitalization, even with him having on and off cough, he didn't lose his appetite nor lost weight. Only now that he is losing weight because the dietetian had to put him on diet because of his hypertension and cholesterol problems and high normal blood sugar. All the specialized test for blood sugar cme out within normal limits. He is about 5 feet 6 inches but was 198 lbs and now is 183 lbs. Thanks so much for taking time to read his long medical history

Answered by Dr. Dr. Rakhi Tayal (3 hours later)

Hello.

Thanks for writing to us.

Having a fever only for two days does not indicate tuberculosis whereas pleural effusion might be due to pulmonary tuberculosis. Since his PPD is positive to confirm if he is having an active lesion he can have examination and staining of pleural fluid sample for AFB or can go for ELISA testing for specific IgM antibodies against T.B.

Tuberculosis is communicable disease. Presence of bacteria in the sputum (sputum AFB positive) increases the chances of spread to other close associates. His doctors would be doing this test along with other mentioned tests. He is less contagious if the sputum AFB test come negative. In general as such the family members should avoid coming in contact with his body secretions like sputum. He should use a separate towel and cover his mouth well while coughing. If the active infection is there he can use a mask to prevent the spread of infection to family members.

Anti tubercular drugs are very good antibiotics and are sometimes used to treat resistant gram positive infections in the body. Prescribing anti TB drugs does not mean he is a diagnosed case of Tuberculosis.

I hope you have found my answer and recommendations to be both adequate and helpful. Should you have additional questions I am available to address them.

Regards.

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

Follow up: Dr. Dr. Rakhi Tayal (3 hours later)

Dear Doctor, thanks for the immediate response. I don't think that the lab kept a sample of the fluid. The doctor didn't order staining for AFB. They had a hard time collecting sputum sample during his hospitalization. A test was done but the result didn't say anything about TB. Sorry the results are not with me on hand. Even the CT angiography didn't reveal anything re TB. Yes, he had been using mask . But since hospitalization he didn't have episodes of coughing , sneezing which he normaly have. I will ask the doctor for Elisa testing for my son. Am I right that after 2 to 3 weeks of taking the prescribed anti TB medication, if ever his infection is active, he will be no longer contagious. He had started the meds about 5 days ago. Is ELisa testing for specific IgM antibody against TB will finally tell us if what he is having contagious or not? My daughter is really very strict on him re prvention of spread so my son would just like to stay in his room that he won't be infecting his sister. This is a big problem to both of them. Thanks agai

Answered by Dr. Dr. Rakhi Tayal (3 hours later)

Hello.

Thanks for writing back.

After starting the treatment of TB, if he is an active case then the chances of transmission are almost negligible after 3-4 weeks of regular treatment.

ELISA test detects presence of antibiotics and indicate about the recent and past infection.

Hope my answer is helpful.

Wish you and your son good health.

Regards

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