Suggest Treatment For TB With Fever And Chills

Posted on Mon, 8 Sep 2014

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Mon, 8 Sep 2014 Answered on

Tue, 30 Sep 2014 Last reviewed on

Question : Hello Doctor, My mother is 58 yrs old & has been diagnosed with TB (montoux test turned out to be 15) and she has been prescribed medicine. She is getting fever (temp goes up to 102) in the evenings. She has chills also. Once she has crocin in the night, fever subsides by mid in the night accompanied by sweat. She has got severe anemia and taking iron tablet. Her heamoglobin was 6.5, 2 mths before and now it got increased to 7.5 .Also during the fever, she faces difficulty in breathing and this difficulty is seen only when she has the fever. How long will she be suffering from this fever and breathing problem? Should i ask her to take any other test? Please prescribe. I am really worried

Answered by Dr. Anshul Varshney (17 minutes later)

Brief Answer:
I need further details.

Detailed Answer:
Dear Friend.
Welcome to HCM. I am Dr Anshul Varshney. I understand your concern.
Such high ESR with fever is indicative of tuberculosis.
I need a few details to help you better :
1. Is she diagnosed to have pulmonary tuberculosis? That is TB of chest?
2. Her Xray and sputum examination was done? If yes attach reports.
3. Since when is she taking Anti Tubercular drugs?
4. Her anemia was diagnosed prior to TB diagnosis or she developed anemia on start of TB medications?
5. Is this her first ESR or a repeat one? If repeated one what was the initial ESR?
Revert with these details.
Stay Healthy.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Anshul Varshney (1 hour later)

Hello Doctor. Thanks for your reply. Yes she has TB. She had taken montoux test scaling 15 and taking anti-tubercular drugs for the past 2 months.

Both X-Ray & scan had indicated TB. Not sure about Anaemia. She was having fever for a week in the evening & had mild cough. After that we took blood test & then took TB related tests/x-ray/scan. Only then we know that she had anemia.

This is her first ESR.
Medication:

RCILEX-600MG - 1-0-0
MICOBUTOL - 1000 MG - 1-0-0
PENADON
PIRALDINA-750 MG - 0-0-2

MONTEC-LC- 0-0-1

Answered by Dr. Anshul Varshney (1 hour later)

Brief Answer:
Detail Follows.

Detailed Answer:
Dear Friend.
Positive montoux test is not diagnostic of Tuberculosis. We need confirmation by getting sputum examination.
But let's consider that she has TB because her ESR is high and as you are saying Imaging is also suggestive of. But she is on drugs for TB since last 2 months!
Fever should have resolved by now.
I am worried for possibility of Multi Drug Resistant Tuberculosis.
I would advise you to get following :
1. Chest Xray Repeat.
2. Repeat Hemogram with ESR
3. Sputum for Acid Fast Bacilli.
4. Sputum for culture and sensitivity.
Review with reports.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar