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Suggest Treatment For Lymph Node TB And TB Meningistis
Question: Hi Doctor,
I am again asking a few questions to you as I am getting puzzled with my mother.
Some important points:-
1) All TB drugs have been discontinued
2) FNAC Test not done(physical examination did ot detect any inflammation of Lymph nodes)
3) Lumbar puncture test not required as said by XXXXXXX Medicine Specialist(cannot do on our own as you can understand)
4) My mother very dedicatedly followed the drug regime only under proper guidance of the Medicine specialist.
5) Some drugs were forced to be discontinued such as:- Pyrazinamide(within 2 months), Isoniazid and Ethambutol(4.5 months), Ofloaxacin(after 7 months) of TB detection
6) She never skipped a single dose or stop all medicines completely
7) She was diagnosed with both Lymph Node TB and TB Meningistis last June(2014).
Please recommend what to do. One of my colleague's brother is a Medicine Specialist who has advised my mother to continue drugs for 6 months more. What exactly can we do?
She has completed Rifamcin(11 months) and Levofloaxcin(5 months).
Thanks and Regards,
XXXX
I am again asking a few questions to you as I am getting puzzled with my mother.
Some important points:-
1) All TB drugs have been discontinued
2) FNAC Test not done(physical examination did ot detect any inflammation of Lymph nodes)
3) Lumbar puncture test not required as said by XXXXXXX Medicine Specialist(cannot do on our own as you can understand)
4) My mother very dedicatedly followed the drug regime only under proper guidance of the Medicine specialist.
5) Some drugs were forced to be discontinued such as:- Pyrazinamide(within 2 months), Isoniazid and Ethambutol(4.5 months), Ofloaxacin(after 7 months) of TB detection
6) She never skipped a single dose or stop all medicines completely
7) She was diagnosed with both Lymph Node TB and TB Meningistis last June(2014).
Please recommend what to do. One of my colleague's brother is a Medicine Specialist who has advised my mother to continue drugs for 6 months more. What exactly can we do?
She has completed Rifamcin(11 months) and Levofloaxcin(5 months).
Thanks and Regards,
XXXX
Brief Answer:
No need to restart TB medications.
Detailed Answer:
HI
Greetings from Dr.Divakara.P
Well in my opinion there is no need to restart TB medicine, she has taken it adequately.
Just observe her general health conditions and if you or the doctor notices any significant changes in her health just revert back to me .
Don't get puzzled , the reason why you get different opinions from different doctors is that , there is no definite protocol like guidelines for treatment TB where the conventional drugs was not used.
So my strong recommendation is no need to restart TB medications.
Regards.
No need to restart TB medications.
Detailed Answer:
HI
Greetings from Dr.Divakara.P
Well in my opinion there is no need to restart TB medicine, she has taken it adequately.
Just observe her general health conditions and if you or the doctor notices any significant changes in her health just revert back to me .
Don't get puzzled , the reason why you get different opinions from different doctors is that , there is no definite protocol like guidelines for treatment TB where the conventional drugs was not used.
So my strong recommendation is no need to restart TB medications.
Regards.
Above answer was peer-reviewed by :
Dr. Neel Kudchadkar
Hi Doctor,
she is suffering from Frozen shoulder(confirmed by Medicine specialist and Orthopedic surgeon) for a month. That time she was taking Rifamcin and Levofloxacin.
1) Is there any case to worry? Is it because of TB or levofloxacin side effects?
2) How long does frozen shoulder take to go?
Thanks and Regards,
XXXX
she is suffering from Frozen shoulder(confirmed by Medicine specialist and Orthopedic surgeon) for a month. That time she was taking Rifamcin and Levofloxacin.
1) Is there any case to worry? Is it because of TB or levofloxacin side effects?
2) How long does frozen shoulder take to go?
Thanks and Regards,
XXXX
Brief Answer:
TB could have caused it.
Detailed Answer:
HI
Well there is no need to worry as Frozen Shoulder ( FS ) as it is not a serious disease. The only problem she may have is restriction of range of motions. For that she needs to get regular physiotherapy which shall help in improving the range of motion .
The cause of FS is difficult to assess, most of the time diseases like Diabetes , Hypothyroidism, trauma, autoimmune diseases have been implicated as the cause but none proven. The common factor among all these is there will be long term inflammation in the body and hence in the joints. The same long term inflammation can be seen in TB and hence it can be assumed that TB might have caused it. But FS doesn't indicate presence or ongoing TB.
No its not due to Levofloxacin.
FS can remain for a long time ( months to years ) . It depends on the physiotherapy given and intensity of exercise done by the patient.
My advise for her is get regular physiotherapy and also let her do the exercise advised by the physiotherapist sincerely.
Hope this information was useful to you.
Any clarifications feel free to ask.
Regards.
TB could have caused it.
Detailed Answer:
HI
Well there is no need to worry as Frozen Shoulder ( FS ) as it is not a serious disease. The only problem she may have is restriction of range of motions. For that she needs to get regular physiotherapy which shall help in improving the range of motion .
The cause of FS is difficult to assess, most of the time diseases like Diabetes , Hypothyroidism, trauma, autoimmune diseases have been implicated as the cause but none proven. The common factor among all these is there will be long term inflammation in the body and hence in the joints. The same long term inflammation can be seen in TB and hence it can be assumed that TB might have caused it. But FS doesn't indicate presence or ongoing TB.
No its not due to Levofloxacin.
FS can remain for a long time ( months to years ) . It depends on the physiotherapy given and intensity of exercise done by the patient.
My advise for her is get regular physiotherapy and also let her do the exercise advised by the physiotherapist sincerely.
Hope this information was useful to you.
Any clarifications feel free to ask.
Regards.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Hi Doctor,
She was thoroughly checked by Medicine specialist and Orthopedic surgeon. They told that lymph nodes are not swollen by clinical examination(TB was detected at the beginning from the same lymph nodes under left armpit).
The Medicine Specialist has asked my mother to do a blood test
The report:-
Basophil-4(Normal is said as 3 or below)
ESR-27(Normal 20 and below)
Lymphocyte:- 44%
WBC-6800(normal below 11000)
others tests are normal-LFT, sugar level, etc.
Thanks and Regards,
XXXX
She was thoroughly checked by Medicine specialist and Orthopedic surgeon. They told that lymph nodes are not swollen by clinical examination(TB was detected at the beginning from the same lymph nodes under left armpit).
The Medicine Specialist has asked my mother to do a blood test
The report:-
Basophil-4(Normal is said as 3 or below)
ESR-27(Normal 20 and below)
Lymphocyte:- 44%
WBC-6800(normal below 11000)
others tests are normal-LFT, sugar level, etc.
Thanks and Regards,
XXXX
Brief Answer:
No need to do anything.
Detailed Answer:
HI
A mild elevation in basophil is of no concern. In my opinion there is no need to test or treat for this basophil elevation. Just repeat the test after 2 months.
The same thing hold good for ESR and Lymphocytes, no need to do anything , Just repeat the test after 2 months.
Regards.
No need to do anything.
Detailed Answer:
HI
A mild elevation in basophil is of no concern. In my opinion there is no need to test or treat for this basophil elevation. Just repeat the test after 2 months.
The same thing hold good for ESR and Lymphocytes, no need to do anything , Just repeat the test after 2 months.
Regards.
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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