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What Causes Recurring Fever In The Afternoon When Suffering From TB Lymphnodes?
Question: Hi,
I was diagnosed with tb lymphnodes on 3 april 13 by mantoux test and ct scan.i completed my treatment AKT on 10 april 14. Taken all tablets properly and on time without missing single dose.
I was feeling normal after 6 months and started working. But now in may 14 that is after 1 month of stopping treatment I started getting feverish in afternoon and was getting terrible fatigue and no energy in my hands and legs .and I went to my dr. when I stoped treatment my esr was 25.fevr shown in thermomter is around 99.9 always.
My dr said it was viral fever and treated me accordingly.
Again I was getting fever in the afternoon, so we did the blood test ,chest xray , esr and widal test. Everything was normal. Esr was 15.
Dr suggested me to wait for 1 month and do the PET CT scan. So I did it on 4th july 14. It says “ NO metabolically active disease found anywhere in the body” and All Lymph nodes are non FDG avid subcentimeter.
I had taken moxif 400 15 hrs before the petct scan for sore throat as suggested by my dr.
Does that moxif has affected my petct scan??
Why I get fever in the afternoon? After I have my lunch I start feeling better again.
I was diagnosed with tb lymphnodes on 3 april 13 by mantoux test and ct scan.i completed my treatment AKT on 10 april 14. Taken all tablets properly and on time without missing single dose.
I was feeling normal after 6 months and started working. But now in may 14 that is after 1 month of stopping treatment I started getting feverish in afternoon and was getting terrible fatigue and no energy in my hands and legs .and I went to my dr. when I stoped treatment my esr was 25.fevr shown in thermomter is around 99.9 always.
My dr said it was viral fever and treated me accordingly.
Again I was getting fever in the afternoon, so we did the blood test ,chest xray , esr and widal test. Everything was normal. Esr was 15.
Dr suggested me to wait for 1 month and do the PET CT scan. So I did it on 4th july 14. It says “ NO metabolically active disease found anywhere in the body” and All Lymph nodes are non FDG avid subcentimeter.
I had taken moxif 400 15 hrs before the petct scan for sore throat as suggested by my dr.
Does that moxif has affected my petct scan??
Why I get fever in the afternoon? After I have my lunch I start feeling better again.
Brief Answer:
Tb lymphnode seems to have subsided.
Detailed Answer:
Hi,
Thanks for posting the query on HCM. After going through your query, I would like to comment the following:
1. Depending on your results, your TB lymphnode seems to have subsided and responded to ATT treatment.
2. Your current bout of fever could be infective. If you were started on an antibiotic course, do complete the treatment course as advised by your physician.
3. A single dose of antibiotic normally does not affect the mediastinal lymphadenopathy or its interpretation on PET scan.
4. Other causes of fever need to be ruled out, if fever is persisting eg: malaria, dengue, typhoid, uti, etc.
I hope I have answered your query. I will be glad to answer follow up queries if any. Please accept my answer if you have no follow up queries.
Regards
Dr. Gyanshankar Mishra
MBBS MD DNB
Consultant Pulmonologist
Tb lymphnode seems to have subsided.
Detailed Answer:
Hi,
Thanks for posting the query on HCM. After going through your query, I would like to comment the following:
1. Depending on your results, your TB lymphnode seems to have subsided and responded to ATT treatment.
2. Your current bout of fever could be infective. If you were started on an antibiotic course, do complete the treatment course as advised by your physician.
3. A single dose of antibiotic normally does not affect the mediastinal lymphadenopathy or its interpretation on PET scan.
4. Other causes of fever need to be ruled out, if fever is persisting eg: malaria, dengue, typhoid, uti, etc.
I hope I have answered your query. I will be glad to answer follow up queries if any. Please accept my answer if you have no follow up queries.
Regards
Dr. Gyanshankar Mishra
MBBS MD DNB
Consultant Pulmonologist
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
thanks for the reply...
1) why i get fever in the afternoon only? after eating i start feeling better.
2) i have not lost much wt in last 2 months, onlt less by 1.5 kg.
3) what is uti?
4) will i be able to work if in case my dr starts second line treatment?
1) why i get fever in the afternoon only? after eating i start feeling better.
2) i have not lost much wt in last 2 months, onlt less by 1.5 kg.
3) what is uti?
4) will i be able to work if in case my dr starts second line treatment?
Brief Answer:
Other causes of fever need to be ruled out
Detailed Answer:
Hi,
Thanks for posting the follow up query. After going through the follow up query, I would like to comment the following:
1. Other causes of fever need to be ruled out as mentioned in previous post. Plz consult your physician regarding the same.
2. No significant weight loss is good.
3. UTI: Urinary tract infection.
4. Fitness to do work will depend on your clinical profile and ability to tolerate the second line drugs if started.
I hope I have answered your query. I will be glad to answer follow up queries if any. Please accept my answer if you have no follow up queries.
Regards
Dr. Gyanshankar Mishra
MBBS MD DNB
Consultant Pulmonologist
Other causes of fever need to be ruled out
Detailed Answer:
Hi,
Thanks for posting the follow up query. After going through the follow up query, I would like to comment the following:
1. Other causes of fever need to be ruled out as mentioned in previous post. Plz consult your physician regarding the same.
2. No significant weight loss is good.
3. UTI: Urinary tract infection.
4. Fitness to do work will depend on your clinical profile and ability to tolerate the second line drugs if started.
I hope I have answered your query. I will be glad to answer follow up queries if any. Please accept my answer if you have no follow up queries.
Regards
Dr. Gyanshankar Mishra
MBBS MD DNB
Consultant Pulmonologist
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
ideally what test do you suggest in my case. kindly suggest all the possible test to rule out any doubts?
what test should be done to check its not tb again??
Brief Answer:
Rule out other causes of fever.
Detailed Answer:
Hi,
Thanks for posting the query on HCM. After going through the query, I would like to comment the following:
1. An internal Medicine Physician opinion to be sough to rule out non pulmonary , systemic causes of fever.
2. Investigations that may be required are Complete bloods count, Urine routine microscopy, Peripheral smear, Malarial anigen test, Widal, Dengue IgG, IgM, HIV etc.
3. Collagen vascular disease profile may be required.
4. If required a CT guided fnac / EBUS guided FNAC may be an option from mediastinal lymph node for cytological diagnosis. Mantoux test may be of help. If required a culture dst from lymph node aspirate may be sent for drug sensitivity testing.
5. The above is a broad framework for further follow up. Choosing the viable options would be done by you pulmonologist / physician after your detailed clinical evaluation.
I hope I have answered your query. I will be glad to answer follow up queries if any. Please accept my answer if you have no follow up queries.
Regards
Dr. Gyanshankar Mishra
MBBS MD DNB
Consultant Pulmonologist
Rule out other causes of fever.
Detailed Answer:
Hi,
Thanks for posting the query on HCM. After going through the query, I would like to comment the following:
1. An internal Medicine Physician opinion to be sough to rule out non pulmonary , systemic causes of fever.
2. Investigations that may be required are Complete bloods count, Urine routine microscopy, Peripheral smear, Malarial anigen test, Widal, Dengue IgG, IgM, HIV etc.
3. Collagen vascular disease profile may be required.
4. If required a CT guided fnac / EBUS guided FNAC may be an option from mediastinal lymph node for cytological diagnosis. Mantoux test may be of help. If required a culture dst from lymph node aspirate may be sent for drug sensitivity testing.
5. The above is a broad framework for further follow up. Choosing the viable options would be done by you pulmonologist / physician after your detailed clinical evaluation.
I hope I have answered your query. I will be glad to answer follow up queries if any. Please accept my answer if you have no follow up queries.
Regards
Dr. Gyanshankar Mishra
MBBS MD DNB
Consultant Pulmonologist
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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