What Does My Lab Test Reports Indicate?

Posted on Mon, 28 Mar 2016

Question: Hi Doc

My father (50 yrs, smoker) has recently being diagnosed for Tuberculosis. His reports xray and doctors prescription is attached herewith. Please suggest if he need to get some additional tests done? Also if the prescription is good to continue with or do we need to change or add some medicines? He has quit smoking now. Is there something to be concerned about? Look forward to your suggestions. Thank you in anticipation.

Answered by Dr. Drkaushal85 (4 hours later)

Brief Answer:
Was he having tuberculosis in past?

Detailed Answer:
Thanks for your question on Health Care Magic.
I can understand your concern.
I have gone through the reports you have attached.
His sputum report is negative for tuberculosis.
His chest x ray is more suggestive of old healed, fibrotic lesions.
So I need to know few things first.
1. Was he having tuberculosis in past?
2. What are his symptoms at present? Does he have hemoptysis (blood in sputum)?
We need to confirm that the x ray lesions are not old, scarred lesion.
Another possibilities are bacterial pneumonia and cancer because both are common in smokers.
So in his case CT scan of thorax and Bronchoscopy are advisable to confirm the diagnosis and rule out adove mentioned possibilities.
Please reply me answers of above asked questions, so that I can guide you better.
I will be happy to help you further. Wishing good health to your father. Thanks.

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

Follow up: Dr. Drkaushal85 (12 hours later)

Thanks doctor.

To answer your questions - I am not sure if he was having tuberculosis before or not; we haven't had him diagnosed for the same. Also, he feels pain while he cough but there was no blood in sputum.

He used to smoke before then he quit and after a gap of approx 8-10 years he started smoking again. Now since he was diagnosed for lung disease hence he is not smoking at all again. Please suggest what to be done next .

Answered by Dr. Drkaushal85 (6 hours later)

Brief Answer:
Does he have weight loss?

Detailed Answer:
Thanks for your follow up question on Health Care Magic.
I can understand your concern.
So he was a smoker. So possibility of tuberculosis, lung infection and lung cancer is more.
So please let me know
1. Does he have fever? Does he have weight loss and decreased appetite?
2. Has he ever undergone CT thorax?
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 (4 hours later)

Hi Doctor
Yes, he had fever, weight loss and decresed appetite. He was down with fever more than a week or so. Then he started complaining for chest pain and we get to know about TB.
Also, no he have not ever gone through CT Thorax.

Answered by Dr. Drkaushal85 (1 hour later)

Brief Answer:
Is he having symptoms since 7 days only?

Detailed Answer:
Thanks for your follow up question on Health Care Magic.
I can understand your concern.
See his sputum report for tuberculosis is negative. So we are not sure that he is 100% suffering from TB.
And hence I need to know few more things to rule out tuberculosis. Possibility of acute pneumonia is more.
1. Is having symptoms since 7 days only? Was he completely asymptomatic before 7 days?
2. Do you have any previous chest x ray to compare?
Please reply me answers of above asked questions, so that I can guide you better. I will be happy to help you further. Wishing good health to your father. Thanks.

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

Follow up: Dr. Drkaushal85 (2 hours later)

Hi Doctor

He was down with fever for say 7-8 days. Fever was fluctuating not constant. After 7-8 days he started experiencing pain in right side of chest. As he was not able to eat properly, was feeling dizzy all the times, his weight has reduced and it was visible from his face hence we consulted another GP. He suggested to get all these tests done (reports attached). Now am not sure what exactly he is suggering from. I will get the thorax CT done as suggested by you.

Also as he have been a somker off and on hence the smokers cough was always there.

Regarding Xray, am sorry but we do not have any other one to compare.

Please suggest. Look forward to your valuable inputs .

Answered by Dr. Drkaushal85 (4 minutes later)

Brief Answer:
Does he have breathlessness?

Detailed Answer:
Thanks for your follow up question on Health Care Magic.
I can understand your concern.
With this short history, tuberculosis is unlikely.
Tuberculosis is having chronic history, almost 1-2 months.
Possibility of pneumonia is more.
But he is having upper lobe lesions. So possibility of tb is high.
Please let me know
1. Is he improving with these drugs? Means coughing and fever subside or not?
2. Is he having breathlessness?
Please reply me answers of above asked questions, so that I can guide you better. I will be happy to help you further. Wishing good health to your father. Thanks.

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

Follow up: Dr. Drkaushal85 (8 minutes later)

Hi Doctor

Yes he is improving with the drugs. No more fever but cough is there off and on. He did not have breathlessness .

Answered by Dr. Drkaushal85 (1 minute later)

Brief Answer:
Consult pulmonologist and get done CT thorax.

Detailed Answer:
Thanks for your follow up question on Health Care Magic.
I can understand your concern.
Since he is improving with tb drugs, possibility of tuberculosis is more.
But better to consult pulmonologist and get done clinical examination of respiratory system.
Also get done CT thorax to rule out other possibility like pneumonia.
Continue with current medicines.
Smoking cessation is must.
Don't worry, he will improve.
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.
Wishing good health to your father. Thanks.

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

Follow up: Dr. Drkaushal85 (9 minutes later)

Many thanks doctor. Just one quick quastion - any pulmonologist which you may suggest in XXXXXXX or XXXXXXX Thanks again for all the help. :)

Answered by Dr. Drkaushal85 (2 minutes later)

Brief Answer:
You can visit fortis or medanta.

Detailed Answer:
Thanks for your follow up question on Health Care Magic.
I can understand your concern.
Honestly speaking, I am not belonging to gurgoan or XXXXXXX so not having much idea about pulmonologist there.
But you will surely get good pulmonologist in corporate hospital like fortis or medanta.
Sorry for this.
Do let me know his progress and follow up.
I will be happy to help you further.
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.
Wishing good health to your father. Thanks.

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