Suggest Treatment For Tuberculous Pleural Effusion

Posted on Mon, 16 Nov 2015

Question: Sir/Madam,

I am suffering from Tuberculous (TB) pleural effusion disease for the last one and half months.

Doctor has given me the following medicines :-
1. Dompan and Rifa-I-6-forte (Morning Empty Stomach)
2. Mycobutol 1000 (1 tablet) and P-Zide 750 (2 tablets), Polybion syrup after breakfast.
3. Polybion syrup after dinner.

I took wysolone 10 mg, 2 tablets for one month.

I am feeling extremely weak and sometimes pain chest and shoulder. Also feeling pain in left side of the chest.

Is the medicines are sufficient and what is the curable time for the disease?

XXXX

Answered by Dr. Drkaushal85 (30 minutes later)

Brief Answer:
Usual time of recovery is 1-2 months.

Detailed Answer:
Thanks for your question on Health Care Magic.
I can understand your concern.
Your drugs are correct and according to standard guidelines.
No need to take wysolone. It is prednisone. It is oral corticosteroid. Current guidelines don't support corticosteroid in pleural effusion.
So better not to take wysolone.
Wysolone can cause weakness.
Usual recovery time is 1-2 months. But you need to take anti tb drugs for atleast 6-8 months.
Since you are not improving with symptoms, I suggest you to get done chest x ray to know the improvement in pleural effusion.
Please let me know
1. Had you undergone pleural fluid aspiration?
2. Have you gained weight? What is your current weight? What was your weight at the starting of treatment?
Please reply me answers of above asked questions, so that I can guide you better.
I will be happy to help you further.
Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (36 minutes later)

Sir,
Thank you for the prompt reply.
1. Pleural fluid aspiration was not done.
2. My weight at the starting of the treatment (13th September)was 76 kg. My current weight is 77.5 kg.
Actually i was suffering from severe dry cough and breathing problem i.e shortness of breathing.

All the reports are attached for your reference.

I had done chest xray on 4th oct. The fluid was not found.

Answered by Dr. Drkaushal85 (49 minutes later)

Brief Answer:
No need to worry. You are improving.

Detailed Answer:
Thanks for your follow up question on HCM.
I can understand your concern.
I have gone through the reports you have attached.
Your recent chest x ray is improved than 1st one.
So no need to worry much for this.
Stop wysolone.
Continue same anti tb drugs for 15 more days to complete 2 months of intensive phase.
Once 2 months are complete, start only rifampicin and isoniazid and continue till 4 months to complete total 6 months of treatment.
Hope I have solved your query.
If you are not having further queries, then please close the conversation and rate my answer.
You can ask me directly on bit.ly/askdrkaushalbhavsar.
Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (38 minutes later)

Thank You Sir...

I am confused about what foods should I take and avoid?

And what precautions should I take?

Regards,
XXXX

Answered by Dr. Drkaushal85 (57 minutes later)

Brief Answer:
Eat high protein diet.

Detailed Answer:
Thanks for your follow up question on HCM.
I can understand your concern.
You should eat high protein diet like pulses, green leafy vegetables, milk and it's products like cheese, butter, paneer etc, protein powder, soyabean etc.
If you are non vegetarian then eggs, meat, chicken etc is also advised.
You can eat all fruits. No harm in fruits.
Better to avoid junk food which is non nutritional. Avoid spicy food.
Continue multivitamin supplements you are taking.
Hope I have solved your query.
If you are not having further queries, then please close the conversation and rate my answer.
You can ask me directly on bit.ly/askdrkaushalbhavsar.
Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (36 hours later)

Sir..

What is the causes of TB pleural effusion. My total ige level is always 10 times more than normal values. It is always 1200

Reagrds,
XXXX
.

Answered by Dr. Drkaushal85 (20 minutes later)

Brief Answer:
Possibility of asthma is more in your case.

Detailed Answer:
Thanks for your follow up question on HCM.
I can understand your concern.
IgE is marker of allergic disease.
And you are having significant raised level.
You are also having coughing and breathlessness.
So possibility of asthma or allergic bronchitis is more in your case.
Please let me know
1. Do you have wheezing or whistling sound during breathlessness or at night?
2. Do you have family history of asthma?
3. Do you have coughing and breathlessness before diagnosis of pleural effusion?
Please reply me answers of above asked questions, so that I can guide you better.
Causes for TB pleural effusion are
1. New infection from the environment.
2. Reactivation tuberculosis.
So please let me know did you have tuberculosis in the past?
Please reply me answers of above asked questions, so that I can guide you better.
I will be happy to help you further.
Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Sonia Raina