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Child Prescribed Akurit For Hydrosalphinx. Mass Sticking To Bladder And Uterus. Had Appendicitis. Is Dosage Correct?

Posted on Mon, 13 Aug 2012

Question: My child underwent appencities operation in 2009. Within 3 days of operation got infected and she had pelvic collection for which pigtail catheter was placed under ultrasound guidance. Drain output has decreased and got dischared. Nov 2011, she had developed pain in the abdomen and found out the problem through MRI - hydrosalphinx and there is a mass sticking to the bladder and uterus (Vol:4.1cc) started Akurit 4 for 2 months and 5 months Akruit 3, 1-0-0. Now as per ultrasound report, child is not having hyrosalphinx and the mass seen in the utero-vesico fold which appeares to be a adherent to both anterior aspect of the uterus as well as to the adjecent bladder wall. This mass appeares to have marginally decrease in size to 2.34.

6 months before Now my daughter was 12 year old, weight 43kg. Doctor was giving Akurit 3 one tab every day. 7 months completed and now the childs weight is 50 kg. The 2nd doctor says that the above dosage is not right, hence advice to take Akruit 3 1-1-1 before 30 minutes for 2 months. The 3rd doctor says to take 2 tab in the morning.
Please guide me, Is the dosage suggested is correct?

Answered by Dr. Sourav Ganguly (1 hour later)

Hi,

Thanks for your query.

Your baby has pelvic tuberculosis which is a form of extra pulmonary tuberculosis the drugs regimen used there is Isoniazid +rifampicin + pyrmaziadide + ethambutol (trade name is Akurit 4) for 2 months as intensive phase followed by rifampicin + isoniazid+ ethambutol (Akurit 3) for at least 4 months as maintenance phase but depends on the report the duration of maintenance phase can be increased up to 12 months.

Akruit 3 contain rifampicin (150 mg/tab) + isoniazid (75mg/tab) + ethambutol (275mg/tab) and doses required depend on the body weight-rifampicin=10 md/kg body weight, isoniazid= 5mg/kg body weight and ethambutol=15 mg/kg body weight as your daughter is having now 50 kg body weight so she need 3 tabs of akruit 3 every day in the morning. Your daughter already took Akruit 3 for 6 months but she may have to take it longer duration depends on response

The primary treating physician will be able to rightly judge the dosage required now for maintenance phase. Please stick to his advice.

Hope I have answered your query. If you have any further questions I will be happy to help.

If you do not have any clarifications, you can close the discussion and rate the answer and write a review.

Wish your child and you good health.

Thanks,
Dr Sourav Ganguly

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. Sourav Ganguly (23 hours later)

The surgeons are saying she may not have tuberclosis and this is related to appendex operation happend, whereas some physicians are saying that she might have TB. I am not clear on which is correct?

Before the Akurit tab, she use to get cold and fever frequently, nose bleeding, too much of gas comining out (since 2009 after appendix operation happend)

After having Akurit tab the above problem is not there now and having only right side abdomen pain(only when we press the abdomen)

Currently for the last 5 days having 2 tabs in the morning. Can I have 2 tab in the morning and 1 in the evening Or shall I give 1-1-1 as I am feared that she might get more gasterics and might start vomitting.

Please advice

Follow up: Dr. Sourav Ganguly (48 minutes later)

This mass appeares to have marginally decrease in size to 2.34.

Answered by Dr. Sourav Ganguly (19 minutes later)

Hi,

Thanks for posting query,

It is to be understood that only tuberculosis can respond to Tablet Akurit. As the mass size is decreased (though marginally) and other symptoms are subsided, so it is probably a case of tuberculosis.

But for confirmation you have to do a CT guided Biopsy from the mass. This then has to be sent for culture for Acid fast bacilli. Please consult your physician about that.

Regarding tab Akurit doses she need 3 tabs, you can give her 3 tabs at morning or1 tab each in morning, evening and night or 2 tabs in the morning and one in the evening.

In this cases also consult your physician about dose schedule.

Hope I have answered your query. If you have any further questions I will be happy to help.

If you do not have any clarifications, you can close the discussion and rate the answer and write a review.

Wish your child and you good health.

Thanks,
Dr Sourav Ganguly

Above answer was peer-reviewed by : Dr. Aparna Kohli

Follow up: Dr. Sourav Ganguly (1 hour later)

As per the scan report the mass is sticking to bladder and uterus, then please let me know why the pain is only from right abdomen(only by pressing)

Answered by Dr. Sourav Ganguly (1 hour later)

Hi,

Thanks for posting query,
Intestinal tuberculosis usually arises from Right side of the intestine (ileum, Right ascending colon). Gradually, other organs adhere to this mass and this is how it would appear on a scan. Appropriate treatment would resolve this mass and she’ll start feeling better soon.
Hope that helps. Let me know if you have any more concerns.

Thanks,
Dr Sourav Ganguly

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Above answer was peer-reviewed by : Dr. Aparna Kohli