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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Small Child, Swelling In Throat, Might Be Tuberculosis Infection. Pus Culture Normal. Treatment?

my baby have a swelling in throat . the doctor done her ultrasound and doubted that she have a tb . after that the x ray is done xray is normal after that the skin test be done . this is 15 mm. after that fnac test done the report are possibly of tb. but after that pus culture are done the report are normal and the doctor giving a antibiotic and the swelling is reducing now what can i do
Mon, 21 Jan 2013
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Pediatrician 's  Response
Hi,

Thank you for your query.

A mantoux test (skin test for TB) of 15 mm and FNAC suggestive of TB need to be discussed and evaluated in the light of clinical findings. Did the FNAC show acid fast bacilli (AFB)? If they were seen then treatment for tiberculosis should be started. However, you mention that the swelling has subsided after a course of antibiotics. In this case I woudl suggest to wait and watch. In case the child does not gain weight or looses weight and the swelling increases then a course of anti-tuberculous treatment is required.

I hope I have answered your query to your satisfaction.

Wishing your baby an early recovery.

Regards,

RKK
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Pediatrician, Neonatology Dr. Aarti Gupta's  Response
thanku for your concern,
well Amit it seems your baby is suffering most probably from tuberculosis , as the skin test u did it came positive and the FNAC is also showing that possibility . there can be two possibility why the swelling is getting reduced with antibiotics 1)there can be secondary infection also which is getting response with that antibiotics 2)the antibiotics that your dr is giving can also be antitubecular like azithromycin which treats normal throat infection as well as it is second line treatment for tuberculosis.
hence my advice will be to go for antitubercular treatment also.consult your pediatrician for that.
i hope i have answered your query,
god bless
Dr Aarti

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Pediatrician, Neonatology Dr. Ravikiran Reddy's  Response
Hello I have gone through your complaints. Swelling in the throat can be mostly a bacterial infection for which your doctor has already prescribed. As your doctor suspected for tb and as your skin test is positive to it , your child needs to under go two more tests to completely rule out the tb. One is early morning gastric aspirate test and other is ESR, blood test .
Thank you. Good day
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Small Child, Swelling In Throat, Might Be Tuberculosis Infection. Pus Culture Normal. Treatment?

Hi, Thank you for your query. A mantoux test (skin test for TB) of 15 mm and FNAC suggestive of TB need to be discussed and evaluated in the light of clinical findings. Did the FNAC show acid fast bacilli (AFB)? If they were seen then treatment for tiberculosis should be started. However, you mention that the swelling has subsided after a course of antibiotics. In this case I woudl suggest to wait and watch. In case the child does not gain weight or looses weight and the swelling increases then a course of anti-tuberculous treatment is required. I hope I have answered your query to your satisfaction. Wishing your baby an early recovery. Regards, RKK