Respected user, hi I evaluated your query thoroughly . - was bacteriological confirmation taken before starting AKT or given empirically - appetite - weight alterations - current status of effusion - WBC counts etc . * Now developed dyspnea suggest that at the commencement of treatment it was not present which indicate that : Koch`s diagnosis is not full proof ( because if AKT was working, there would not have been dyspnea after it ) * I recommend to undergo # Diagnostic bronchoscopy with cytology of lavage fluid # Sputum culture * In my opinion you require intensive treatment of this as Acute lower respiratory tract infection with Koch`s under investigation , in our clinic we recommend higher IV antibiotics , bronchodilators , supportive measures , steroids in selected cases . Hope this clears your query . Welcome for any further assistance . Thanks for using Healthcaremagic.com & giving me an opportunity to assist Wishing you fine recovery from the same . Regards dear take care .