What Causes Persistent Cough And Blood In Sputum While Treating Tuberculosis?

Posted on Tue, 3 Jan 2017

Question: Hi, Its me again, TB patient in UK with sore throat complaint.

I had been to ENT specialist and he examined my mouth and inserted thin camera through my nose to see the throat. Fortunately he did not find anything serious other than some inflammation in throat. He said I am suffering from "Silent Reflux" and my sore throat and occasional ear discomfort is from reflux. He prescribed me Lansoprazole 30mg to take once a day first thing in morning for two months. He said I should see improvement on my throat in two months time. Lets hope it happens. Also he said the white pus filled lump near tonsil was likely tonsil stone and there is still bit of left.

He pointed out that occasional blood in mucus was not coming from the throat as he could not see any reason that it could come fro throat. He said it was from Lungs. My TB doctor was also certain that it was from lungs. TB doctor had said that due to TB infection bronchi and all can become inflamed and blood can come in sputum. TB doctor said even after my TB is gone small amount of blood can come.

I want to know:
1> My TB treatment is in 5th month now and I am currently on Isoniazid and Rifampicin. Why still blood in mucus? Its not regular but why?
2> The blood is coming from the lungs according to doctors. When do you think it should stop if its from lungs?
3> Do you think ENT doctor is right in his diagnosis? Since taking Lansoprazole for two days I feel slight better in my throat.

Any more advise will be appreciated.

Thanks & Regards.

Answered by Dr. Priyanka Aggarwal (1 hour later)

Brief Answer:
Chronic tonsillitis with tuberculosis

Detailed Answer:
Hi XXXX..
I remember our first conversation..
1..In tuberculosis, the disappearance of symptoms like cough, or blood in sputum can take sometime to disappear
2..You should complete your ATT course..if bleeding is very light and just occasionaly, you can relax but if you find it too often like everytime you cough than according to me..it should be investigated..the best is than go for a CECT CHEST
3. Your ENT has done an endoscopic throat examination and it is quite helpful in diagnosis..what he says is right and you should continue with lansoprazole..alongwith the various lifestyle measures i mentioned before..
In chronic tonsillitis, tonsillolith is a very common thing..don't worry about that, it will disappear spontaneously..just make a habit of gargling once daily with saline water
Wishing you a speedy recovery
Regards

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Priyanka Aggarwal (22 hours later)

Hi Dr Aggarwal,

Thanks for your detailed answer. It always comforts me when I know what is happening with me.

My latest X-ray seemed ok. My latest blood results (FBC, LFT, CRP etc) were within normal range so I think I need not worry.

I am not coughing up blood everyday. Only 3-4 times during last 3 months and in very small quantity together with mucus only.

Do you suggest any other investigation or tests at the moment??

Regards,
XXXX XXXXXXX

Answered by Dr. Priyanka Aggarwal (36 minutes later)

Brief Answer:
Hemoptysis with chronic tonsillitis

Detailed Answer:
Hi XXXX
m glad to know that all your reports are finw and you are also doing good. Just relax, no more tests required..just be compliant to your medicines.
Wishing you a speedy recovery.
Regards

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Above answer was peer-reviewed by : Dr. Prasad