Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Suggest Treatment For Persistent Fever And Vomiting
Question: Hi, i am 25 years old and mother of 2 year kid. On aug 8th 2016 my fever started and it prolonged 3 weeks about 104'f but i dint hv any other symptom other than fever. I was taking antibiotics for viral infection . After that chest xray was taken and pleural effusion was noticed. Fliud was taken and clinical study happened. Though all were negative ADA value was 69. So they found it as tb. I am taking akt4 from sep 2nd and still i have fever upto 102. And also vomiting is there after the start of medication. Can somebody help why is this fever still there. Also will this affect my kid?
Brief Answer:
It appears to be tubercular pleural effusion.
Detailed Answer:
Hello XXXX,
Thanks for posting your query on HCM.
One of the main causes of pleural effusion is TB especially in people of Indian/Asian origin. You have not given the details of findings of pleural fluid analysis but a ADA level as high as 69 goes in favour of tubercular nature of pleural fluid. Was a skin test called Montoux test done? Generally in tubercular pleural effusion it is positive.
I am sure that your doctors have decided to start you on AKT4 after ruling out all other possibilities. Sometimes high grade fever may continue for a long time even after starting the TB treatment. In my opinion you should continue taking TB treatment and fever will settle down soon. At times a short course of oral steroids helps in controlling high grade fever. You may discuss it with your treating physician.
Generally tubercular pleural effusion is not very infectious but I do hope that you do not have any TB infection in the lungs. You may ask your doctor about it. If lung infection is also there, child may have to be put on Isonizide preventive therapy.
I hope this answers your query.
It appears to be tubercular pleural effusion.
Detailed Answer:
Hello XXXX,
Thanks for posting your query on HCM.
One of the main causes of pleural effusion is TB especially in people of Indian/Asian origin. You have not given the details of findings of pleural fluid analysis but a ADA level as high as 69 goes in favour of tubercular nature of pleural fluid. Was a skin test called Montoux test done? Generally in tubercular pleural effusion it is positive.
I am sure that your doctors have decided to start you on AKT4 after ruling out all other possibilities. Sometimes high grade fever may continue for a long time even after starting the TB treatment. In my opinion you should continue taking TB treatment and fever will settle down soon. At times a short course of oral steroids helps in controlling high grade fever. You may discuss it with your treating physician.
Generally tubercular pleural effusion is not very infectious but I do hope that you do not have any TB infection in the lungs. You may ask your doctor about it. If lung infection is also there, child may have to be put on Isonizide preventive therapy.
I hope this answers your query.
Above answer was peer-reviewed by :
Dr. Veerisetty Shyamkumar
Hello doctor,
Thank you so much for your reply.
I am mentioning the analysis of fluid below.
Histopathology impression: pleural fluid smears and cell block, negative for malignant cells
Clinical pathology:
Color: pale yellow
Apprearace:slightly turbid
Wbc 2140
Rbc 2750
Neutrophiles 02%
Lymphocytes 98%
Biochemistry:
Glucose 68
Protein 5.0 rbc present
Ldh 1927
These are the fluid analysis doctor.
I am taking ethambutol 1000mg , pyrazinamide 1500 mg, isoiazid 300mg, rifampicin 600 mg. Benadon 40 mg according to my ht and wt.
But i feel tired through out the day doctor .Not able to talk to others normally .
For me its right sided effusion. And its paining on the right side constantly. Also nausea and vomiting is there alternately.
Thank you so much for your reply.
I am mentioning the analysis of fluid below.
Histopathology impression: pleural fluid smears and cell block, negative for malignant cells
Clinical pathology:
Color: pale yellow
Apprearace:slightly turbid
Wbc 2140
Rbc 2750
Neutrophiles 02%
Lymphocytes 98%
Biochemistry:
Glucose 68
Protein 5.0 rbc present
Ldh 1927
These are the fluid analysis doctor.
I am taking ethambutol 1000mg , pyrazinamide 1500 mg, isoiazid 300mg, rifampicin 600 mg. Benadon 40 mg according to my ht and wt.
But i feel tired through out the day doctor .Not able to talk to others normally .
For me its right sided effusion. And its paining on the right side constantly. Also nausea and vomiting is there alternately.
Brief Answer:
The pleural fluid analysis goes in favour of tuberculosis
Detailed Answer:
The pleural fluid analysis goes in favour of tuberculosis and the tb treatment you are taking is correct including the dosages of various drugs.
You have to continue the treatment. You may take some pain killer for the pain and fever or a short course of oral steroids as suggested by me earlier after discussing with your doctor. This may also help in rapid drying of pleural fluid.
I am sure your doctors are monitoring you well. If the high grade fever continues after 4 to 6 weeks of tb medicines, they may have to rule out secondary bacterial infection.
The pleural fluid analysis goes in favour of tuberculosis
Detailed Answer:
The pleural fluid analysis goes in favour of tuberculosis and the tb treatment you are taking is correct including the dosages of various drugs.
You have to continue the treatment. You may take some pain killer for the pain and fever or a short course of oral steroids as suggested by me earlier after discussing with your doctor. This may also help in rapid drying of pleural fluid.
I am sure your doctors are monitoring you well. If the high grade fever continues after 4 to 6 weeks of tb medicines, they may have to rule out secondary bacterial infection.
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
