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What Causes Hypokia And Deterioration In Health?

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Posted on Mon, 17 Mar 2014
Twitter Mon, 17 Mar 2014 Answered on
Twitter Mon, 14 Apr 2014 Last reviewed on
Question : This is regarding my dad.have attached both sides of the CT scan report.One done in Oct - Post this we had done Tb culture which was normal after 6 weeks..This scan was Oct by Nov end he contracted pneumonia klebsella.We did the Ct scan in Oct and waited for the TB culture which was due in Nov end.Post which we were planning Ct biopsy and or bronchoscopy.Did we delay it or was he deterioating? What did this Oct CT scan reveal.In this period of 1.5 months......did the Ct indicate pnemonia or is that something else he contracted. Post which he was treated in hospital but the lung retained a slight haze. Bronchoscopy was also done but didnt show any major issues. He got hypokia and was intubated twice but they couldnt figure what was wrong.In ICU the infection was controlled and wbc came down to 10 and later 6 he was going to be shifted to the ward when last 2 days he suddenly could not breathe properly and was going to be intubated when he passed away due to sudden dip in bp and cardiac arrest. My question is: was cancer the only other test which we needed to do? His breathing deteriorated on 25th dec and he had to be put on ventilator on 26th he passed away.We have not been able to get closure and wonder what the reason was and a month back he seemed totally ok Should he have been on bed rest and not gone out at all in this period..........since Tb was negative we assumed its not so serious in that phase.T
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Answered by Dr. Indu Kumar (1 hour later)
Brief Answer: He had positive findings in october report. Detailed Answer: Hello XXXX Thanks for writing to HCM It is very sad to hear about the incidence. He had positive findings in october report which needed further evaluation.It was difficult to diagnose exactly from CT Scan. Main concern was cavitatory lesions which might be tuberculosis(or other infection) or neoplastic(Cancer).Exact nature of lesion can only be ascertained by biopsy and histopathology. Whereas december report shows that along with consolidation (infection),there is also pleural effusion means fluid in pleural cavity (right > left) which shows deterioration of his condition.His lymph node also showed necrotic appearance which was more in favour of tuberculosis. I don't think he had cancer.He passed away due to complications from infections. Pneumonia klebsiella infection might have caused deterioration in his health. Hope I have answered your question. Further queries are most welcome. Take Care Dr.Indu XXXXXXX
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Indu Kumar (21 hours later)
Thank you dr. 1) CT in Oct -we waited for Tb 6 week report -so did we delay treatment 2) Interim he got klebsiella -how does one contract this? 3) If not TB then why does all symtoms (lymph etc show TB?) 4) Whatwas this other infection -he did XXXXXXX etc but nothing showed positive. 5) Was this sudden as he was under treatment evry month witha pulmonologist -towards Aug/sept cough wouldnt go REgards XXXX
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Answered by Dr. Indu Kumar (59 minutes later)
Brief Answer: Please find detail answer below. Detailed Answer: Hello XXXX Thanks for writing back CT scan is not confirmatory for diagnosing tuberculosis.PCR test could had been done for early diagnosis of T.B. He might got Klebsiella infection form recurrent hospital visit.This is the most common way of transmission now a days. Immunocompromised persons are more prone to develop klebsiella infection.It is very notorious. XXXXXXX is not very sensitive to pick parenchymal infection. Beside this, he also had interstitial lung disease so his lung capacity was already compromised and unfortunately he developed two types of infection.These factors combined altogether lead to deterioration of his condition. Hope I have answered your question. Further queries are most welcome. Take Care Dr.Indu XXXXXXX
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Indu Kumar (2 hours later)
- he did the test which is a patch test and then waited for the 6 week blood test report. Which was also negative......so was it TB ? - He already had a cough with slight spots of blood on 25th night -sowe admitted as he was getting breathless -so would he have had it then or got within 2 days in hospital? - The infection which he got if not TB what do you suspect if not canceras thats the one which we could not diagnoze - what could have saved him - he ahd no problem at all till Nov except cough -in 2 weeks everything got worse and itwas over within amonth.We ahd no inkling he had sucha sever infection.What should we ahve done as test whichwe missed.
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Answered by Dr. Indu Kumar (19 hours later)
Brief Answer: Please find detail answer below. Detailed Answer: Hello XXXX Thanks for writing back There was diagnostic dilemma in october scan.Tuberculosis causes necrotic lymphadenopathy which was lacking in october report.However,necrotic lymph nodes was evident in december report which strongly indicate towards T.B. Culture and patch test can be negative.It is not very sensitive test. PCR test could had been save time. Lung caner couldn't be confirmed without biopsy. I think his condition deteriorated due to compromised lung status.These infection causes catastrophe in compromised state. Hope I have answered your question. Further queries are most welcome. Take Care Dr.Indu XXXXXXX
Above answer was peer-reviewed by : Dr. Shanthi.E
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Dr. Indu Kumar

Radiologist

Practicing since :2004

Answered : 6728 Questions

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What Causes Hypokia And Deterioration In Health?

Brief Answer: He had positive findings in october report. Detailed Answer: Hello XXXX Thanks for writing to HCM It is very sad to hear about the incidence. He had positive findings in october report which needed further evaluation.It was difficult to diagnose exactly from CT Scan. Main concern was cavitatory lesions which might be tuberculosis(or other infection) or neoplastic(Cancer).Exact nature of lesion can only be ascertained by biopsy and histopathology. Whereas december report shows that along with consolidation (infection),there is also pleural effusion means fluid in pleural cavity (right > left) which shows deterioration of his condition.His lymph node also showed necrotic appearance which was more in favour of tuberculosis. I don't think he had cancer.He passed away due to complications from infections. Pneumonia klebsiella infection might have caused deterioration in his health. Hope I have answered your question. Further queries are most welcome. Take Care Dr.Indu XXXXXXX