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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Diagnosed With Lymph Node Tuberculosis. Prescribed AKT4, No Relief. Treatment For Infection?

My wife has been diagonesd with TB in lymphnodes near Neck , vertebra... ..my wife weight is 44 kg, doctor has advised 3 tablets of AKT4 after heavy breakfast everyday but even after 6 weeks of tablets hardly there is improvement..improvement is just 1 to 2 %..we are worried now..she has unbearable pain from last 1.5 months in neck/head area.
Sun, 31 Mar 2013
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General & Family Physician 's  Response
HI,
Welcome to HCM.
Tuberculous lympahadenitis is one of the difficult conditions to treat.
It might take just 3 weeks in few people for the clinical response and in some people it might take months.
Severe and unbearable pain is suggestive of suppuration ( lymph nodes fill with pus) and the pain must be like some one stabbing in her neck.

As you have mentioned that your wife has no improvement, here are the two possible options that should help your wife.

Drainage of the lymph nodes( abscess drainage non dependant) will help her in relieving the pain and the mass effect. Though the pain is relieved the wound might take long to heal( which should not be a major concern).
Adding Streptomycin injection to the existing AKT4 regimen will also help her.

My suggestion would be to see a general surgeon and get the abscess drained if possible and add streptomycin to your regimen.

Hope this works for your wife. meanwhile use Tramadol for the pain relief.

Wish your wife a speedy recovery.
Regards
Dr K. Sai Rajesh
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General Surgeon Dr. Hari Charan Perigela's  Response
Hi
The course of Tuberculosis is for 6- 9 months.
It will take some more time for signs of improvement.
Please consult a Surgeon as Abscess may form in the lymph node in TB.The pus has to be aspirated.
Wish her good health and speedy recovery
Regards
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1 Doctor agrees with this answer

General & Family Physician Dr. Shashi's  Response
Hello,

Usually the treatment for tuberculosis has an intensive phase (2-3months) and a continuation phase is for 5-6 months.Totalling the treatment for about 9-12 months according to her response to treatment.

Tests are done usually after 2 months to see the improvement in the condition and treated accordingly.For the pain ,ask the doctor to change the analgesics for relief.

Take care.
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Diagnosed With Lymph Node Tuberculosis. Prescribed AKT4, No Relief. Treatment For Infection?

HI, Welcome to HCM. Tuberculous lympahadenitis is one of the difficult conditions to treat. It might take just 3 weeks in few people for the clinical response and in some people it might take months. Severe and unbearable pain is suggestive of suppuration ( lymph nodes fill with pus) and the pain must be like some one stabbing in her neck. As you have mentioned that your wife has no improvement, here are the two possible options that should help your wife. Drainage of the lymph nodes( abscess drainage non dependant) will help her in relieving the pain and the mass effect. Though the pain is relieved the wound might take long to heal( which should not be a major concern). Adding Streptomycin injection to the existing AKT4 regimen will also help her. My suggestion would be to see a general surgeon and get the abscess drained if possible and add streptomycin to your regimen. Hope this works for your wife. meanwhile use Tramadol for the pain relief. Wish your wife a speedy recovery. Regards Dr K. Sai Rajesh