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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Tuberculosis

Disease: Tuberculosis (lymph nodes on left side of neck) Medical Information: 1. During end of Dec 2010, 5 small formations (lymph nodes) appeared on my left side of neck. One lymph node started growing in size. 2. On January 2011, biopsy was done on the big sized lymph node (removed too). 3. Biopsy report confirmed TB. I was put on AKT-4 4. Till Feb end, small sized lymph nodes subsided but one lymph node appeared and grew larger in size. On March 15 and April 05, Puss was removed and then it busted around April 15 because of puss accumulation. After dressing for one week, Lymph node totally disappeared. 5. Around 10 May 2011, one new lymph node appeared. Puss was removed on 28th may and was tested for Micro-bacterial culture, see the report attached. 6. Starting July 2011, very first lymph node that was removed for biopsy started growing, I was given streptomycin injections starting from July 19, 2011; lymph node subsided after 60 injections. Around Sept 5-2011, same lymph node reappeared. Streptomycin was stopped after 73 doses. 7. Around Sept 10-2011, I noticed one new lymph node below the existing one. 8. On Oct 1, very first lymph node that had appeared again was removed and biopsy was performed. See the report attached. 9. Check the attachment (page 21-28) for detailed information on drugs used during treatment. 10. I used to smoke 3-4 cigarettes daily during treatment. Now I have quitted smoking after 30 Sep. 11. Micro-bacterial culture test on removed lymph node tissue has been ordered. Report will be available by Oct 15 2011. 12. My weight was 53 kg when I started treatment; it went up to 66 kg in August and then again decreased to 64 Kg. ( For past 8 months my diet had been very healthy compared to time before treatment) Attachment covers the tests conducted and medicines taken along with dates. Question: Need expert opinion on what could have gone wrong during 8 months of treatment and also on how to go for further treatment? What could be the estimated period of treatment? Can any two different specialists supervise my further treatment? PS: keep my medical history private and reference to my case shall not appear anywhere on online or offline forum. Also avoid generic views while answering my question.
Mon, 2 Apr 2018
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Pulmonologist 's  Response
Hello,

Gene expert or other tests for drug resistance need to be done. Also, the correct dose of ATT needs to be check for your weight. Other comorbidities need to be ruled out.


Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Gyanshankar Mishra
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Suggest Treatment For Tuberculosis

Hello, Gene expert or other tests for drug resistance need to be done. Also, the correct dose of ATT needs to be check for your weight. Other comorbidities need to be ruled out. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Gyanshankar Mishra