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Suggest Treatment For Tuberculous Lymphadenitis

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Posted on Sat, 6 May 2017
Question: if at all with tubular lymphadenitis treatment for six months in total for six months if at all we miss five day dose means for six months if at all we miss five day dose ,then also my treatment will be successful
my lymph node regressed in second month only and I have no symptoms from starting.the missing of dose is accidentally not by choice and also the dose missing is not continuous but accidentally while traveling
doctor
Answered by Dr. Gyanshankar Mishra (1 hour later)
Brief Answer:
Always complete the full course of anti TB medications

Detailed Answer:
Hi,
Thanks for posting your query on HCM. After going through your query, I would like to comment the following:
1. The minimum duration of recommended treatment for TB lymphadenitis is 6 months which may be extended to 9 to 12 months by your doctor based on your clinical evaluation and response as assessed by the doctor.
2. It is good that after 2 months, there is symptomatic improvement in your case.
3. However you need to complete the full course of treatment else, there will be a very high chance of the lymphadenitis appearing again.
4. Completing the full course of treatment is important to fully treat the TB lymphadenitis.
I hope, I have answered your query. Please do let me know, if there are any follow up queries.
Dr. Gyanshankar Mishra
MBBS MD Pulmonary Medicine DNB MNAMS
Consultant Pulmonologist
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Gyanshankar Mishra (27 minutes later)
sir my lymph node regressed fully in the second month only now I don't have any swallow lymph node even it is very difficult to find out....and my question is if there is any missing of dose in overall treatment of six months for nearly five days will there be any negative impact I am taking daily dose of Akurit 3 for last six months , never missed a day but sir for six months continuous is difficult to remember each day medicine, hence asking if at all there is any miss of dose in overall six months course for nearly five days will it effect treatment
doctor
Answered by Dr. Gyanshankar Mishra (43 minutes later)
Brief Answer:
It should not affect significantly

Detailed Answer:
Hi,
1. Missing 5 doses in a period of 6 months should not usually cause very significant effect. There is nothing that can be done now on the missed doses, however it is recommended not to miss even a single dose for optimum result. Missing doses are a risk factor for adverse treatment outcome.
2. You need to clinically follow up with your doctor for treatment assessment.
3. Local tomography of the neck in consultation with your doctor may help in assessing the current status of the lymph node and future course of treatment.
Dr. Gyanshankar Mishra
MBBS MD Pulmonary Medicine DNB MNAMS
Consultant Pulmonologist
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Gyanshankar Mishra (3 hours later)
Sir this attached report is my first report during starting of my treatment,as of missing dose is concerned I am asking you because it is difficult for me to recall each day dose.and I maintained my notebook for my daily dose and calculations for my daily purchase and consumption matched.i hardly missed any dose but I still want to Know if at all there is miss of dose will there is any effect
doctor
Answered by Dr. Gyanshankar Mishra (9 hours later)
Brief Answer:
If you hardly missed any dose then no need to worry.

Detailed Answer:
1. Considering that your physician had diagnosed Tubercular Lymphadenitis, you need to trust the clinical assessment of your physician.
2. I do not see any attached reports along with your query. However if Xray was done and seen by your physician, you need to refer to the Xray report and confirm with your examining physician if Xray was normal. It is important that "whether you had any chest symptoms?" which you haven't reported in any of your previous queries. Thus the chances of XXXXXXX chest involvement are less.
3. You should not be worried over missing one or two doses especially which you do not remember. The treatment will remain the same and will not differ if you miss a dose here or there.
4. That clinically the lymph node has subsided signifies that you are clinically improving and hence any adverse outcome from this stage is less likely.
5. Please do not be worried as a relaxed mindset is equally important in having a good treatment outcome.
6. Please remember that a single missed dose solely leading to an adverse outcome is less likely and hence do not be worried.
7. Only important point for you is to regularly follow up with your physician as advised and not to stop the medication on your own.
Dr. Gyanshankar Mishra
MBBS MD Pulmonary Medicine DNB MNAMS
Consultant Pulmonologist
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Gyanshankar Mishra (9 hours later)
sir attaching my first x ray report and FNAC
doctor
Answered by Dr. Gyanshankar Mishra (36 hours later)
Brief Answer:
Reports are suggestive of TB

Detailed Answer:
Hi,
After going through your reports, I would like to comment the following:
1. FNAC from cervical lymph node is suggestive of TB.
2. The x-ray film shows rotation of the patient. However there is possibility of mediastinal adenopathy. This may be found in TB. A repeat chest x-ray with proper centralisation will help assess current status. If any mediastinal lymphadenopathy is suspected in current chest xray, then a ct scan may be advised by your physician.
3. In such a scenario, the total duration of anti tb treatment may be increased to 9 to 12 months by your physician.
Dr. Mishra
MBBS MD Pulmonary Medicine DNB
Consultant Pulmonologist
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Gyanshankar Mishra (11 minutes later)
sir I am attaching my third month x ray report taken on date.1/2/2017
doctor
Answered by Dr. Gyanshankar Mishra (34 minutes later)
Brief Answer:
CT scan of thorax may help

Detailed Answer:
Hi,

1. The feb x-ray chest findings reveal a possibility of mediastinal adenopathy.

2. CT scan of the thorax in consultation with your physician may help in assessing the mediastinal nodes.

3. Extension of anti TB therapy to 9 to 12 months could be considered by your physician.

Dr. Gyanshankar Mishra
MBBS, MD Pulmonary Medicine DNB
Consultant Pulmonologist
Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Follow up: Dr. Gyanshankar Mishra (17 minutes later)
sir my treatment started on 5th November the first xay that was attached taken on 11th November again in second month my lymph node in the neck subsided fully ,my physician taken PA chest on completion of third month that is the February x ray so can't I stop my treatment after six months that in may
doctor
Answered by Dr. Gyanshankar Mishra (6 minutes later)
Brief Answer:
You should not stop treatment without your doctor's advice

Detailed Answer:
Hi,

1. You should not stop treatment without your doctor's advice.

2. It is usually recommended to assess the size of lymph nodes either clinically or by sonography as deemed fit by your physician prior to taking any decision regarding stopping Anti TB treatment.

3. If required then the duration of treatment can be increased by your physician.

Dr. Gyanshankar Mishra
MBBS MD Pulmonary Medicine DNB
Consultant Pulmonologist
Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
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Dr. Gyanshankar Mishra

Pulmonologist

Practicing since :2003

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Suggest Treatment For Tuberculous Lymphadenitis

Brief Answer: Always complete the full course of anti TB medications Detailed Answer: Hi, Thanks for posting your query on HCM. After going through your query, I would like to comment the following: 1. The minimum duration of recommended treatment for TB lymphadenitis is 6 months which may be extended to 9 to 12 months by your doctor based on your clinical evaluation and response as assessed by the doctor. 2. It is good that after 2 months, there is symptomatic improvement in your case. 3. However you need to complete the full course of treatment else, there will be a very high chance of the lymphadenitis appearing again. 4. Completing the full course of treatment is important to fully treat the TB lymphadenitis. I hope, I have answered your query. Please do let me know, if there are any follow up queries. Dr. Gyanshankar Mishra MBBS MD Pulmonary Medicine DNB MNAMS Consultant Pulmonologist