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Why It Didn't Cured Even 7 Months Daily Treatment Without Skip For Cervical Lymph Node TB?

Posted on Tue, 13 Aug 2024

Question: Hi doctor. I am 44 years old. March 2022 i diagnoised for cervical lymph node TB. Doctor started treatment with Rcinex 450, combutol 800, benadon 40 and pyzina 750. Also i continued treatment around 7 months (pyzina 750 only 2 months). After 7 months trestment supraclavicular lymphnode also strarted to swollen. Day by day swollen this lymph node increased its size. Scanning image showed around 3 cm large. FNAC done. FNAC report showed lymphnode tuberculosis with cold adscess. Doctor told to surgical remove. Now surgically removed swollen lymph nodes and sent to lab for biopsy. Surgery done on december 28, 2022. Biopsy report also shows lymph node tuberculosis. CBNAAT negative. Doctor again started treatment (dec 30 2022) with Rcinex 450, pyzina l000 and combutol 800 mg. Is it treatment ok or wrong treatment? Please advice me correct treatment. Please tell reason why it didn't cured even 7 months daily treatment without skip?

Answered by Dr. Dr.Raju.A.T (7 hours later)

Brief Answer:
Treatment is right

Detailed Answer:
Hi,

Thanks for your query.

Yes, the drug combination is right for now. In case CBNAAT showed positive with resistance pattern there might a change in the drugs. Since its negative the only combination we can use is as same as advised.

Giving you second course of ATT is mandatory as there is proof for treatment failure.

Regards,

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Dr.Raju.A.T (2 hours later)

Doctor, Thank you for your answer.
Doctor please answer me given below doubts
what is ATT?
Rcinex, combutol and pyzina must take together before food at morning?
Can I take combutol at noon after food?
Also please advise which food must take and which food must avoid?
Thank you so much doctor

Answered by Dr. Dr.Raju.A.T (22 hours later)

Brief Answer:
Answered below

Detailed Answer:
Hi,

Thanks for writing back.

ATT - Anti Tubercular Treatment
Rcinex must be taken before food, combutol and pyina after food
Its advisable to take all drugs in the same session
Consider high protein, low fat and low spicy diet

Regards,

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Dr.Raju.A.T (25 hours later)

How I know now taking treatment working or no? Because already surgically removed Swollen lymphnodes. So cannot do FNAC.
Doctor, please advise me if availabe any blood test or any other kind of diagnose for findout treatment works or no. Thank you

Answered by Dr. Dr.Raju.A.T (20 hours later)

Brief Answer:
Lymphocyte count

Detailed Answer:
Hi,

The best test is on Lymph node only but you can indirectly track the TB by lymphocytes in complete blood count. Higher counts are seen in active TB.

Regardsm

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