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Suggest Treatment For Pulmonary Tuberculosis
Question: I had a pus collection on my chest, on the CT scan it showed a pus has colleceted eroding my chest bone and moreover there was another mass between the trachea and the lung, the doctor diagonised it as a non-pulmonary tuberculosis, and have been taking Pyzina 750 (2tab), Combutinol 1000, and RCinex 600 for the first two months, I have also been taking Streptomycin for the first one month daily, for the second month, injection was administered 3 times a week , during the third month, the pus was completely gone , the injection and Pyzina was stopped and I continue to take Combutinol and RCinex . I was asked to take Digital X ray to check the progree. The X ray showed the presence of mass , though the size couldn't be ascertained. What shall be the further action. The doctor now recommends me to take L - Cin 500 ,along with combutinol and R-Cinex. Please say is this the correct procedure?. Has the first level has failed?. What is the normal time it takes for the nodal mass to fully disappear ?. Should not the L Cin be taken after 6 to 9 months once the first level treatment of TB has completely failed ?
Brief Answer:
Anti TB treatment to be continued with monitoring.
Detailed Answer:
Hi,
Thanks for posting the query on HCM. After going through your query, I would like to comment the following:
1. You seem to have been started on anti tb treatment for ? tubercular empyema with mediastinal mass ? lymphadenopathy.
2. In such cases a microbiological diagnosis of TB usually helps before start of treatment.
3. Daily streptomycin during the first 2 months along with other drugs would have been better choice. Considering that the pus has gone down, it seems that anti tb treatment is showing some response.
4. I would not advocate addition of LCIN (levofloxacin) in patient who aren't confirmed mdr tb.
5. A follow up ct scan of thorax after 6 months of initiation of anti tb treatment should help us gauge the response to ATT.
6. I would advise you to get yourself evaluated by a Pulmonologist at the earliest.
I hope I have answered your query. I will be glad to answer follow up queries if any. Please accept my answer if you have no follow up queries.
Regards
Dr. Gyanshankar Mishra
MBBS MD DNB
Consultant Pulmonologist
Anti TB treatment to be continued with monitoring.
Detailed Answer:
Hi,
Thanks for posting the query on HCM. After going through your query, I would like to comment the following:
1. You seem to have been started on anti tb treatment for ? tubercular empyema with mediastinal mass ? lymphadenopathy.
2. In such cases a microbiological diagnosis of TB usually helps before start of treatment.
3. Daily streptomycin during the first 2 months along with other drugs would have been better choice. Considering that the pus has gone down, it seems that anti tb treatment is showing some response.
4. I would not advocate addition of LCIN (levofloxacin) in patient who aren't confirmed mdr tb.
5. A follow up ct scan of thorax after 6 months of initiation of anti tb treatment should help us gauge the response to ATT.
6. I would advise you to get yourself evaluated by a Pulmonologist at the earliest.
I hope I have answered your query. I will be glad to answer follow up queries if any. Please accept my answer if you have no follow up queries.
Regards
Dr. Gyanshankar Mishra
MBBS MD DNB
Consultant Pulmonologist
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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