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On AKT 4 Since Months For Spinal TB. Advised AKT2. Right Treatment?

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Posted on Thu, 13 Jun 2013
Question: I am on AKT 4 since feb 13,2013 for suspected TB of the spine.now my doctor has asked me to star with AKT 2 from XXXXXXX 13,2013 for one year and 2 months.is the prescription ok? Today i noticed blurring of vision and rashes on upper arms.how and when these problems subside?
My dr is a neurologist and he got quantiferron done on me which was positive though when i consulted at indian spinal injuries centre and one more orthopaedic they said i dont have tb of spine.thn i got USG done and montoux done also which tested 20 mm positive but nothing in USG of abdomen.but since i had started the medicine i am continuing it.plz advise.
doctor
Answered by Dr. Shoaib Khan (10 hours later)
Hello and welcome to XXXXXXX

Thank you for writing to us.

A quantiferon test is the registered standard test to diagnose an active or latent tuberculosis infection, and if it does return positive, it could mean that you have a TB infection. A mantoux test in your case has also reported a positive result. USG abdomen might not be able to pick up much; instead, an x-ray of the spine would be more accurate. If you indeed have TB of the spine (also called pott's spine), there should be any of the following changes on an x-ray of the spine:
-Collapse of a vertebral body
-Anterior wedging would be increased
-Lytic destruction of anterior part of the vertebral body
-Increased psoas shadow
-Calcification can be present or not
-Reactive sclerosis
and a few other changes, you will have to confirm these changes with your doctor.

The regimen suggested is correct, although the two drugs that are advised during the continuation phase (isoniazid, ethambutol or pyrazinamide)from XXXXXXX 13th are advised for 6 months, I suggest you to visit your doctor after 6 months, and only if required continue the dose for another 6 months.

The side effects you are experiencing are due to the medication Isoniazid (allergic reaction and visual disturbances), unfortunately these might continue till you are on the medication. I request you to please consult your treating doctor regarding the same.

I hope I have provided all the information you were looking for. If there is anything I have forgotten to address or if you have any further clarifications, please do write back to me. I would be more than happy to help you.

Best wishes.
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Above answer was peer-reviewed by : Dr. Shanthi.E
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Answered by
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Dr. Shoaib Khan

General & Family Physician

Practicing since :2009

Answered : 9409 Questions

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On AKT 4 Since Months For Spinal TB. Advised AKT2. Right Treatment?

Hello and welcome to XXXXXXX

Thank you for writing to us.

A quantiferon test is the registered standard test to diagnose an active or latent tuberculosis infection, and if it does return positive, it could mean that you have a TB infection. A mantoux test in your case has also reported a positive result. USG abdomen might not be able to pick up much; instead, an x-ray of the spine would be more accurate. If you indeed have TB of the spine (also called pott's spine), there should be any of the following changes on an x-ray of the spine:
-Collapse of a vertebral body
-Anterior wedging would be increased
-Lytic destruction of anterior part of the vertebral body
-Increased psoas shadow
-Calcification can be present or not
-Reactive sclerosis
and a few other changes, you will have to confirm these changes with your doctor.

The regimen suggested is correct, although the two drugs that are advised during the continuation phase (isoniazid, ethambutol or pyrazinamide)from XXXXXXX 13th are advised for 6 months, I suggest you to visit your doctor after 6 months, and only if required continue the dose for another 6 months.

The side effects you are experiencing are due to the medication Isoniazid (allergic reaction and visual disturbances), unfortunately these might continue till you are on the medication. I request you to please consult your treating doctor regarding the same.

I hope I have provided all the information you were looking for. If there is anything I have forgotten to address or if you have any further clarifications, please do write back to me. I would be more than happy to help you.

Best wishes.