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Suggest Treatment For TB

Posted on Thu, 26 Dec 2013

Question: Good Evening Sir May I ask you sir that I have 10 years old son who sometimes spits reddish in color(sometimes after 5days, 10 days , sometimes 3 days) since XXXXXXX 2013, otherwise spitting is of normal color as everybody else does . Doctor advised Limcee tab which he took for about -1-1/2 months, but of no avail.Then another doctor whom we consulted advised a series of tests(copies attached) and then since XXXXXXX 2013 treatment is on.We see no appreciable progress since he still spits reddish sputum, again sometimes after4 days , sometimes 6 days with no set time table.Ostensibly we feel he is getting weaker and taking of ABT drugs so long is creeping in his mind and may be affecting his psyche. Because he is taking so much medicine, previuosly 8 tablets a day and now 2 to four tablets a day and process is on. How about a check up in one of Delhi hospitals.Can we solicit your expert opinion on it. If so kindly advise a good hospital .Friends her are referring Sir GangaRam Hospital. kindly advise as your view shall carry some weight. XXXX

Answered by Dr. Shashi Dangwal (1 hour later)

Brief Answer: He needs further investigations. Detailed Answer: Hello XXXX, You have not mentioned if your child has any other symptoms like fever, cough, wt loss etc. No x ray report is attached. One sputum report shows growth of MTB which is the bacteria which causes TB. You have not given the details of treatment but he could have been started on TB treatment. If the treatment has been taken regularly without gaps, he should have shown improvement by now. Since you feel there is no improvement he needs to be investigated further to rule out drug resistant TB or any other cause for Blood in sputum. Yes Gangaram is a good hospital and you may show him there. Then there is XXXXXXX Chest Institute and LRS hospital. These both are govt hospitals which deal mainly in chest disease.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Shashi Dangwal (1 hour later)

Thanks doctor for speedy response.The X-ray of chest was conducted.Other symptoms are non existent no weight loss as such, no fever , sneezing , coughing ect. Normal as else. Treatment was for tuberclosis which is on without fail

Answered by Dr. Shashi Dangwal (9 hours later)

Brief Answer: It still could be TB, Endobronchial TB. Detailed Answer: Hello XXXX, Thanks for further inputs. Even if your child `s chest x ray is normal, he could still be having a form of TB called Endobronchial TB in which generally x ray is normal. But you have mentioned that he has no symptoms, then how is it that you feel he is getting weaker. He also has a sputum test positive for TB bacteria, but reliability of test as well as lab is to be kept in mind. I do hope that there is no local cause for bleeding like gums or throat. He may need further tests like CT scan of chest, bronchoscopy and a repeat sputum culture for MTB. Hence as suggested earlier, it`s better that you take him to a higher centre. Take care.

Above answer was peer-reviewed by : Dr. Prasad