Sign-in to Ask A Doctor - 24x7
OR
Sign in with GoogleGet your health question answered instantly from our pool of 18000+ doctors from over 80 specialties
Suggest Best Medications For Pulmonary TB
HI,
My relative was diagnosed with pulmonary TB last year - April(2010). Symptoms were only fever and weakness no cough nothing. Medicines were started for TB in May 2010. They gave 4 salt ( Rifampicin, Ethambutol, Isoniozide, Pyrazinamide and an antibiotic Zanocin). This 4 salt was taken by her for 5 weeks after thar due to some prb they made it to three salts. But she took this 3 salt combination for 8 days. After that the doctor again started the 4 salt combination. Please Note: The Medicine was continued but for 8 days the medicine was made to 3 salt combination instaed of 4 salt. so may be we can say: after 6 weeks she was again started on the full course again as her fever has not gone . So from June again her treatement started from scartch with 4 salt medicines and contined for three mnths with 4 salt combination and after that she was given medicines of 2 salt combination for other 6 mnths. So a total of 10 mnths she was on medication. She was not having fever after that. But then doctor did the Xray and found that the lymph nodes in the chest were still there. (she also had a lymphnode in the neck) They took the FNAC of that neck lymphnode and did the culture as well. The culture came out negative but the smear was positive for bacteria still after 10 mnths. They stopped the medicines and did the FNAC and culture again. so for almost 3 mnths they stopped the medicines. Now they again started the new course of medication in June 2011 with the following combination: Rifampicin, Izoniozide, Pyrazinamide, Zanocin, Streptomycin injections (as there is puss in the lymph nodes seen on chest Xray)
The treatement was again started after 3 mnths gap and while taking treatement again, she started fever again. This course is almost 3 mnths now, and just 2 days back we went to doctor and did the x-ray, BUT the doc says Puss is still there....
even after 85 streptomycin injections along with TB medicines, the desease is not reponding to medicines. They have again done the FNAC of the lymphnode in neck and have sent it for Culture as well.
Now we do not know what to do. FNAC smear comes positive and culture always negative and still fever does not goes and puss is also still there in chest lymph nodes.
Is it some resistant bacteria or something else. What combinations of medicines should we use, it is almost 1.5 yrs but no response...........
Pls suggest some thing.
My relative was diagnosed with pulmonary TB last year - April(2010). Symptoms were only fever and weakness no cough nothing. Medicines were started for TB in May 2010. They gave 4 salt ( Rifampicin, Ethambutol, Isoniozide, Pyrazinamide and an antibiotic Zanocin). This 4 salt was taken by her for 5 weeks after thar due to some prb they made it to three salts. But she took this 3 salt combination for 8 days. After that the doctor again started the 4 salt combination. Please Note: The Medicine was continued but for 8 days the medicine was made to 3 salt combination instaed of 4 salt. so may be we can say: after 6 weeks she was again started on the full course again as her fever has not gone . So from June again her treatement started from scartch with 4 salt medicines and contined for three mnths with 4 salt combination and after that she was given medicines of 2 salt combination for other 6 mnths. So a total of 10 mnths she was on medication. She was not having fever after that. But then doctor did the Xray and found that the lymph nodes in the chest were still there. (she also had a lymphnode in the neck) They took the FNAC of that neck lymphnode and did the culture as well. The culture came out negative but the smear was positive for bacteria still after 10 mnths. They stopped the medicines and did the FNAC and culture again. so for almost 3 mnths they stopped the medicines. Now they again started the new course of medication in June 2011 with the following combination: Rifampicin, Izoniozide, Pyrazinamide, Zanocin, Streptomycin injections (as there is puss in the lymph nodes seen on chest Xray)
The treatement was again started after 3 mnths gap and while taking treatement again, she started fever again. This course is almost 3 mnths now, and just 2 days back we went to doctor and did the x-ray, BUT the doc says Puss is still there....
even after 85 streptomycin injections along with TB medicines, the desease is not reponding to medicines. They have again done the FNAC of the lymphnode in neck and have sent it for Culture as well.
Now we do not know what to do. FNAC smear comes positive and culture always negative and still fever does not goes and puss is also still there in chest lymph nodes.
Is it some resistant bacteria or something else. What combinations of medicines should we use, it is almost 1.5 yrs but no response...........
Pls suggest some thing.
Wed, 13 Aug 2014
I think you should also send routine culture of that pus. Sometimes TB and other bacterial infection can occur togather. The other thing oli would like to know is the weightpatient AKT given according to weight or not. And sometimes dead bacilli can give smear possitive but culture negative as they are dead and do not cultivate. You can also go for pus genexpert. Genexpert is new test which is based on RT PCR and result will tell weather TB bacilli present or not and if present they are Rifampicin sensitive or resistant. And beauty of this test is that it requires only 2-3 hours for the result.
I find this answer helpful
Disclaimer: These answers are for your information only and not intended to replace your relationship with your treating physician.
This is a short, free answer.
For a more detailed, immediate answer, try our premium service
[Sample answer]
Related questions you may be interested in
Recent questions on Tuberculosis
Loading Online Doctors....