Question: This case pertains to my sister in law who is 48 years old. In July 2016 she was diagnosed with high blood sugar. She tested negative for thyroid. In November 16 she had severe breathing problems and we had consulted with E&T specialist in a major new XXXXXXX hospital. Her weight at that time was 33.5 Kgs. Her blood reports showed lot of variations from the standard ranges including high platelet counts . Chest X Ray showed extensive B/L infiltration. She was given augmentin and vizylac and montek lc and advised Echo and CT Chest test.

Multislice CECT exam of chest revealed large areas of pacification's and cavitary lesions involving bilateral lung fields with necrotic mediastinal lymphadenopathy strongly suggestive of tubercular urology. Patient was given akuri-t4,rablet, and others attention wen 25th Nov 16. Patient showed marginal improvement after 4 weeks.

Check up in mid XXXXXXX 17 showed marginal weight increase to 34 Kg but not much change in X Ray. However, towards end of February 2017 she started having severe breathing problems. Patient was advised to have another CECT Chest done and was also recommended for giving an oxygen support. She is being given oxygen support twice a day at home by way of a Oxygen Concentrator. SPO2 levels after this were 90% where as otherwise it was 85%.

CECT Chest of 1 Mar showed Enlarged right para tracheal , aorta pulmonary window and subcarinal lymph nodes and also a large lymph node seen in porta with necrosis. Early march tests showed marginal improvement in blood chemistry parameters but patient still weak and breathing problems.

Bronchoscopy done on 11th March was one showed low detection of micro bacterium TB. Cytology tests showed no granuloma and bronchial aspirate was negative for atypical cells. Patient was advised Ultrasound whole abdomen which showed hypo echoic lesion of 44.9X23mm near porta.

Recent blood reports have indicated that she suffers from hypothyroidism. She started medicines for this also.

She is under treatment for TB

Need second opinion and advise.

Thanks Doctor

I have uploaded 3 reports - will be uploading bronchoscopy reports also
Patient is improving and breathing has improved
Recent doctor visits we have been confirmed that both ultrasound and ct chest are referring to same node which is a TB node
Further 2nd opinion suggested

I have sent all the reports by mail to YYYY@YYYY as per reply received to the problem i reported to web site. Request your review and advise please. Thanks

Thank You Doctor. Here are the responses.

1, Treatment for Tuberculosis started in the last week of Nov 2016. She was prescribed Akurit-4 (2 tablets) empty stomach. From March 16, 2017 onwards she was prescribed i) R-cinex 450 mg and ii) Combutol 600 mg (01 each) empty stomach.

2. Yes, she is taking the drugs together.

3. For diabetes she has been prescribed Diamicron-XR 60 mg and Galvus Met 50/500

4. Her fasting sugar is between 84 - 100 and PP is between 100 - 135 . Her fasting sugar level on 15.04.2017 was 98.

Request advise