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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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How Is Pulmonary Tuberculosis Diagnosed?

Hello online doctors. I recently diagnosed with Pulmonary Tuberculosis. I had my Chest Xray done with infiltrates right upper lobe. Impression: Pneumonia vs PTB. The doctor advised me to take 10 days Levofloxacin then repeat CXR. Still no changes. I had my GENE Xpert done which came out negative. I don t have any of Tuberculosis symptoms. So what I did is consult a Pulmonologist. After seeing my CXR she immediately diagnosed me with PTB. I told her I don t have any symptoms and I feel healthy. My Gene Xpert is negative. She replied to me saying that Gene Xpert are only 50% accurate. So she took her prescription pad and wrote down TB meds that I should take for 6 months. I am still in a state of denial. Eventhough I am not really convinced, I still started the TB meds for a week now. Is this how doctors diagnosed patient with Tuberculosis? Do I really have TB? Am I misdiagnosed?
Wed, 5 Sep 2018
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General Surgeon 's  Response
Hi,

As per the recent WHO guidelines, the diagnostic criteria are multiple levels and beyond complete scope of this online platform, but still, I am narrating salient features herewith to help your case.
@ Tuberculosis diagnosis firstly must be confirmed via microscopy such as sputum, gene expert, lymph node biopsy or else when X-ray chest is normal or inconclusive.
@ Supportive data of symptoms as weight loss, persistent fever, anorexia, cough are vital co relations to be considered.
@ The response to primary treatment of underlying pathology and its regular evaluation on periodic basis is the foundation of giving trial anti tuberculous treatment.

As per my clinical experience, I would say you to take second expert opinion with a pulmonologist.

Hope I have answered your query. Let me know if I can assist you further.
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How Is Pulmonary Tuberculosis Diagnosed?

Hi, As per the recent WHO guidelines, the diagnostic criteria are multiple levels and beyond complete scope of this online platform, but still, I am narrating salient features herewith to help your case. @ Tuberculosis diagnosis firstly must be confirmed via microscopy such as sputum, gene expert, lymph node biopsy or else when X-ray chest is normal or inconclusive. @ Supportive data of symptoms as weight loss, persistent fever, anorexia, cough are vital co relations to be considered. @ The response to primary treatment of underlying pathology and its regular evaluation on periodic basis is the foundation of giving trial anti tuberculous treatment. As per my clinical experience, I would say you to take second expert opinion with a pulmonologist. Hope I have answered your query. Let me know if I can assist you further.