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Suggest Ideal Treatment For TB Meningitis
Question: Hi Sir
My Fiancee is suffering from TB meningitis from XXXXXXX 2016. Her age 28. She was admitted in hospital and in ICU for 5 days and in normal ward for 10 days. later she discharge from hospital.
streptomycin injection given for 2 months and now she's taking TB medicines. Starting she use to take r cinex 600mg tablet, pyzina 1500 MG Tablet, mcin 400mg, benadon 40mg, zenoxa OD 450 for morning and evenings, wysolone 20mg three times, wysolone gradually decrease and now one time taking 5 mg only. While this medicines using she feel sum side effects like headache and vision loss. But vision slowly improving. Since one week she is not hungry and feeling often pain in stomach and feet. We did LFT test in that SGOT and SGPT high 145 and 110 respectively.Her bilirubin level is normal only. Then doctor removed r cinex 600 mg tablet and given solonex 300 mg. Now this tablet going on since 2 days. Since 3 days she is feeling fever with chills at night time only. I'm giving combiflame tablet. Which doctor told to me give whn fever comes.. But why night time only coming and her feet and hands sum time too cold or too hot. Night she getting high fever and shivering. Morning time vomiting sensation is there. I jst want to know that she should not ill again very badly.. She is not feeling sleepy also at night time. Not hungry also. Night time fever and chills is normal or abnormal.. Feet also feeling pain. Kindly suggest me her situation..
My Fiancee is suffering from TB meningitis from XXXXXXX 2016. Her age 28. She was admitted in hospital and in ICU for 5 days and in normal ward for 10 days. later she discharge from hospital.
streptomycin injection given for 2 months and now she's taking TB medicines. Starting she use to take r cinex 600mg tablet, pyzina 1500 MG Tablet, mcin 400mg, benadon 40mg, zenoxa OD 450 for morning and evenings, wysolone 20mg three times, wysolone gradually decrease and now one time taking 5 mg only. While this medicines using she feel sum side effects like headache and vision loss. But vision slowly improving. Since one week she is not hungry and feeling often pain in stomach and feet. We did LFT test in that SGOT and SGPT high 145 and 110 respectively.Her bilirubin level is normal only. Then doctor removed r cinex 600 mg tablet and given solonex 300 mg. Now this tablet going on since 2 days. Since 3 days she is feeling fever with chills at night time only. I'm giving combiflame tablet. Which doctor told to me give whn fever comes.. But why night time only coming and her feet and hands sum time too cold or too hot. Night she getting high fever and shivering. Morning time vomiting sensation is there. I jst want to know that she should not ill again very badly.. She is not feeling sleepy also at night time. Not hungry also. Night time fever and chills is normal or abnormal.. Feet also feeling pain. Kindly suggest me her situation..
Brief Answer:
She is on correct line of treatment.
Detailed Answer:
Hi,
Thank you for posting your query.
I am Dr Sudhir Kumar, Neurologist and would try my best to help you.
I have noted the clinical details of your fiancee and her current problems.
So far, the treatment has gone along correct lines.
1. The current fever with chills could be an unrelated infection, which would settle down in a few days if it is viral fever.
2. If fever continues for more than 5-7 days, we should look for alternative causes such as malaria, urine infection, typhoid, etc with appropriate blood and urine tests.
In very rare cases, the TB bacteria may be resistant to routine anti-TB medicines (called as multi-drug resistant TB). This should be considered if no other cause of fever is obvious and fever continues for more than two weeks. In this situation, the TB medicines would be changed to second line drugs.
I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information.
Wishing you good health,
Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, XXXXXXX XXXXXXX
Click on this link to ask me a DIRECT QUERY: http://bit.ly/Dr-Sudhir-kumar
My BLOG: http://bestneurodoctor.blogspot.in
She is on correct line of treatment.
Detailed Answer:
Hi,
Thank you for posting your query.
I am Dr Sudhir Kumar, Neurologist and would try my best to help you.
I have noted the clinical details of your fiancee and her current problems.
So far, the treatment has gone along correct lines.
1. The current fever with chills could be an unrelated infection, which would settle down in a few days if it is viral fever.
2. If fever continues for more than 5-7 days, we should look for alternative causes such as malaria, urine infection, typhoid, etc with appropriate blood and urine tests.
In very rare cases, the TB bacteria may be resistant to routine anti-TB medicines (called as multi-drug resistant TB). This should be considered if no other cause of fever is obvious and fever continues for more than two weeks. In this situation, the TB medicines would be changed to second line drugs.
I hope my answer helps. Please get back if you have any follow up queries or if you require any additional information.
Wishing you good health,
Dr Sudhir Kumar MD (Internal Medicine), DM (Neurology) XXXXXXX Consultant Neurologist
Apollo Hospitals, XXXXXXX XXXXXXX
Click on this link to ask me a DIRECT QUERY: http://bit.ly/Dr-Sudhir-kumar
My BLOG: http://bestneurodoctor.blogspot.in
Above answer was peer-reviewed by :
Dr. Yogesh D
Hi, I have provided some attachments. Please review them.
Thanks for reply doctor..
Since 3 days she is vomiting after taking morning medicines. earlier she is not vomiting but now for the past three days she vomiting. Doctor given me cocid dsr tablet to take empty stomach. i given that tablet with empty stomach after that 40 mins i given juice to her after 20 mins i given Tb medicines. then exactly after one hr she got vomit and sum time un digest tablet comes out. So kindly explain
1) Why vomit happening since 3 days after taking medicines
2) If she vomit un digest medicines also in that case i have to give again medicine to her ?
3) what kind of diet i shd give to her.. (Now taking juices)
she feeling fear to take anythg food for vomiting reason. earlier she is use to take good food and active. since sum days she feeling tired soon and not taking food. i discuss with doctor all these he told dnt worry.. but i didnt get any explanation from him so it makes me worry. Doctor told me her blood report SGOT SGPT high so all these happen. But i want to know whether i shd worry abt this vomiting and check with him again. should i go for any further tests related to anythg? kindly let me know doctor
Thanks for reply doctor..
Since 3 days she is vomiting after taking morning medicines. earlier she is not vomiting but now for the past three days she vomiting. Doctor given me cocid dsr tablet to take empty stomach. i given that tablet with empty stomach after that 40 mins i given juice to her after 20 mins i given Tb medicines. then exactly after one hr she got vomit and sum time un digest tablet comes out. So kindly explain
1) Why vomit happening since 3 days after taking medicines
2) If she vomit un digest medicines also in that case i have to give again medicine to her ?
3) what kind of diet i shd give to her.. (Now taking juices)
she feeling fear to take anythg food for vomiting reason. earlier she is use to take good food and active. since sum days she feeling tired soon and not taking food. i discuss with doctor all these he told dnt worry.. but i didnt get any explanation from him so it makes me worry. Doctor told me her blood report SGOT SGPT high so all these happen. But i want to know whether i shd worry abt this vomiting and check with him again. should i go for any further tests related to anythg? kindly let me know doctor
Brief Answer:
Reviewed the reports.
Detailed Answer:
Thank you for getting back with reports.
I have reviewed the reports of blood tests, MRI brain and lumbar puncture (CSF analysis).
Based on that, correct treatment has been advised.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Brief Answer:
Vomiting is related to high SGOT and SGPT.
Detailed Answer:
Thank you for getting back with more information.
1. I agree with your doctor that vomiting is related to high SGOT and SGPT, which indicates liver damage, caused due to TB medicines. Those medicines have been stopped, but it takes 1-2 weeks to get back to normal.
2. If the medicines come out or if vomiting happens within 30 minutes of taking tablets, you can give the medicines again.
3. Soft diet, low in spices and oil, should be given. Fruits, fruit juices, idli, khichdi, etc can be given.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Reviewed the reports.
Detailed Answer:
Thank you for getting back with reports.
I have reviewed the reports of blood tests, MRI brain and lumbar puncture (CSF analysis).
Based on that, correct treatment has been advised.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Brief Answer:
Vomiting is related to high SGOT and SGPT.
Detailed Answer:
Thank you for getting back with more information.
1. I agree with your doctor that vomiting is related to high SGOT and SGPT, which indicates liver damage, caused due to TB medicines. Those medicines have been stopped, but it takes 1-2 weeks to get back to normal.
2. If the medicines come out or if vomiting happens within 30 minutes of taking tablets, you can give the medicines again.
3. Soft diet, low in spices and oil, should be given. Fruits, fruit juices, idli, khichdi, etc can be given.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by :
Dr. Veerisetty Shyamkumar
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