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TB Suspected, AFB Culture, Mantoux Skin Test Positive, Bronchial Alveolar Lavage, Lesions, On Nexpro RD, Akurit, Benadon

Posted on Fri, 25 May 2012

Question: Hi, am 26yrs of age, male, ... during the my VISA medical tests, doctors have suspected TB based on X-ray. The tests that were done and the results are given below,
1. Smear negative for AFB using Bronchial Alveolar Lavage (collected after bronchoscopy)
2. Smear negative for AFB with Sputum samples ( 2 days)
3. Mantoux skin test -- postive (18mm)
4. X-ray (lesions on top left and right lungs)
5. AFB Culture (sputum) is done - am waiting for the report
6. Have no cough or weight loss

With this Doctor suspected TB and suggested the medicine...
My weight = 50 KGs (since almost 4 years same weight +/-2 kgs)
Height = 6 feet

Nexpro RD 40, Daily 1-0-0 (One tablet in morning, 30 minutes before food)
Akurit-4, Daily : 2-1-0 (Morning 2 tablets, afternoon 1 tablet, none in night, all are taken one hour after the food)
Benadon, Daily 0-0.5-0 (Morning 0 tablets, afternoon half-tablet, none in night, all are taken one hour after the food)

Incidentally, I consulted another doctor, he said the dosage is not correct. He also suggested me to get CRT scanning done, which I have done now and will get the report tomorrow.
Now, am in confusion.

Is it TB?
Is the dosage okay?

Answered by Dr. Dr. Rakhi Tayal (3 hours later)

Hello,

Thanks for writing to us.

Your X-ray chest is suggestive of tubercular lesions and the tuberculin test is also positive. These two things are an indication enough to start anti tubercular treatment even if your AFB staining and culture are negative.

The treatment you are getting is also correct with proper instructions as to when to take which tablet. You need not worry about the diagnosis and you need to take the full course of anti- tubercular treatment.

Regarding the CRT scan, the results will be almost the same as you got on X-ray. I would have suggested an MRI of chest to my patients as it would have given a better idea about the extent of spread of the lesion.

I hope my answer and recommendations are adequate and helpful. Waiting for your further follow up queries if any.

Regards.

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

Follow up: Dr. Dr. Rakhi Tayal (18 hours later)

Thank you Doctor.
As I had told, I have got the CT scan reports today and after seeing it the Dr. (to whom I have been for second opinion) has told me that, I have active TB-infection and changed the dosage to
1. Akurit-4, 3 tablets (30 mins before breakfast),
2. Benadon -40, 1 tablet every alternate day, anytime.

He also said, nobody gives Akurit-4 twice a day.

Now, am in confusion, whether to follow first doctor or second doctor.
1. Please clarify on this
2. If it is active TB, will it infect others, say in my family, or in the office - my colleagues ?

Answered by Dr. Dr. Rakhi Tayal (44 minutes later)

Hello,

Thanks for writing again.

Both the doctors are correct as taking all three tablets at the same time may cause gastritis.

The motive of giving one tablet in afternoon was to decrease acidity only.

Benadon one tablet on alternate day is same as taking a half tablet daily.

You can follow the second doctor's advise as I feel it is comfortable for you.

Yes, during active TB, you can spread it to others in your family.

Cover your mouth while coughing and and dispose off your sputum immediately.

Do not share your towel, etc with others.

Hope I have answered your query.

Wishing you an early recovery.

Regards,

Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Shanthi.E