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Pulmonary Tuberculosis,akurit 4,severe Back Pain

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Posted on Tue, 29 May 2012
Question: I've been diagonised with pulmonary tuberculosis one and half month back and my chest physician prescribed AKurit 4- one tablet half an hour before breakfast daily. I weigh 41 kgs. Is the dose correct for my weight ? I have severe back pain from past 4days. Am I likely to get Extrapulomonary TB??
doctor
Answered by Dr. Deepak Anvekar (43 minutes later)
Hello,

Thanks for your query.

AKURIT-4 film-is a combination of 4 medicines including - rifampicin 150 mg, isoniazid 75 mg, ethambutol 275 mg, pyrazinamide 400 mg.

This is a standard dose for adults above 18 years and is adequate for in your case as well.

In case you have been taking the prescribed medicine correctly for the past 1.5 months, then you might be on the way to improvement and you might not be transmitting the bacterial anymore.

To confirm this, a sputum testing for the TB bacteria, can be done 3 consecutive samples.

The chances of you developing extrapulmonary TB in other sites could be higher. The main risk factors for such a situation include :
1. Female sex
2. HIV positive status
3. Malnourished and low body weight.
4. Age less than 25 years

Since you seem to have 3 of the above points, the risk is higher. But this does not mean that you will definitely develop TB at other sites of the body. if continuous and regular treatment is continued for at least 6 months with regular checking of sputum to check for efficacy of treatment, you might get cured of the pulmonary TB.

You might consult your treating doctor for regular checking of liver and renal function tests, as well continuation of the anti TB treatment. In addition, you might also benefit by consulting with a dietitian, who can provide proper nutritional support which can help you to gain weight over time.

I hope this answers your question effectively.

I will be available for follow up queries if any.

Regards,

Dr. Anvekar.
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Deepak Anvekar (24 minutes later)
Hi,
Thank you for the quick reply. One quick question... how will I finally confirm I am 100% cured? Would a TB skin test help?? and should my family members have the same drill?
doctor
Answered by Dr. Deepak Anvekar (20 minutes later)
Hello again,

As I had mentioned in the answer, confirmation of cure is done by repeating the testing for sputum for the TB bacteria. Three consecutive samples of the sputum have to be clear from AFB to confirm that you are free from the disease.

But doing the test within 2 months after starting the treatment does not mean that you can stop the treatment, in case the results are normal. You need to continue the treatment for the whole period of 6 months (at least) so that recurrances do not occur.

With regard to your family members, sputum testing will also help to rule out the status of infection.

For your information, TB skin tests - are not used neither for screening or confirmation of TB. It is just a indicator of the risk of infection after a possible exposure.

I hope this helps to clear your doubts.

Regards.

Dr Anvekar.
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Deepak Anvekar (9 hours later)
Oh but I got all negatives for AFB in the sputum tests. Disease was confirmed only after chest X-ray and CT.
doctor
Answered by Dr. Deepak Anvekar (11 hours later)
Hi,

Confirmation of pulmonary TB with Chest Xray and CT scan Chest is not documented anywhere.

We generally take TB culture or Sputum for microscopy as good results for confirmation.

I suggest you should consider taking a second opinion with an Infectious disease specialist in your city or visit District TB centre.

Hope you understand my perspective.

Regards.
Above answer was peer-reviewed by : Dr. Raju A.T
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Answered by
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Dr. Deepak Anvekar

General & Family Physician

Practicing since :2003

Answered : 336 Questions

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Pulmonary Tuberculosis,akurit 4,severe Back Pain

Hello,

Thanks for your query.

AKURIT-4 film-is a combination of 4 medicines including - rifampicin 150 mg, isoniazid 75 mg, ethambutol 275 mg, pyrazinamide 400 mg.

This is a standard dose for adults above 18 years and is adequate for in your case as well.

In case you have been taking the prescribed medicine correctly for the past 1.5 months, then you might be on the way to improvement and you might not be transmitting the bacterial anymore.

To confirm this, a sputum testing for the TB bacteria, can be done 3 consecutive samples.

The chances of you developing extrapulmonary TB in other sites could be higher. The main risk factors for such a situation include :
1. Female sex
2. HIV positive status
3. Malnourished and low body weight.
4. Age less than 25 years

Since you seem to have 3 of the above points, the risk is higher. But this does not mean that you will definitely develop TB at other sites of the body. if continuous and regular treatment is continued for at least 6 months with regular checking of sputum to check for efficacy of treatment, you might get cured of the pulmonary TB.

You might consult your treating doctor for regular checking of liver and renal function tests, as well continuation of the anti TB treatment. In addition, you might also benefit by consulting with a dietitian, who can provide proper nutritional support which can help you to gain weight over time.

I hope this answers your question effectively.

I will be available for follow up queries if any.

Regards,

Dr. Anvekar.