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Q. My CT abdomen shows TB and few cortical cyst in kidneys. What is the treatment?

Answered by
Dr. Divakara P
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Dec 15, 2019

Hello doctor,

My father had a sudden weight loss. CT abdomen was done. It shows likely TB etiology and few cortical cysts in the bilateral kidney. The previous infection was found in the urine culture report.

Dr. Divakara P

Diabetology Endocrinology General Medicine Internal Medicine Pain Medicine Pulmonology (Asthma Doctors)
#

Hello,

Welcome to icliniq.com.

Weight loss can definitely be explained by TB (tuberculosis) abdomen but before starting TB medicines it requires confirmation of TB for which you may require a biopsy test. If you can kindly upload the CT (computed tomography) abdomen report I can tell you which part have to be biopsied? The renal cortical cyst is not of significance if your serum creatinine (blood test) is in normal limits.

You said that previous infection was found in urine culture report, when exactly it was done? Were you treated for that, if not kindly upload the report?


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Thank you doctor,

This is in regards to my dad aged 62 years. PFA herewith the CT abdomen report and urine culture report for your kind reference.

CT abdomen report says diffuse thickening of small bowel loops and omentum with nodular deposits with multiple mesenteric lymph nodes likely TB etiology and a few cortical cysts in the bilateral kidneys.

My question is, can we start the treatment according to this report or is it compulsory to have a biopsy test? And how long will it take to stop weight loss as it is going drastically down as I am afraid for my dad? Weight has reducted from 90 kg to 69 kg in three months and importantly he has lost seven kg in the last five days (from 75 kg to 69 kg). Please suggest. Urine culture report was conducted a week ago and infection was found. Amikacin -high, Levofloxacin-medium, Imipenem-high and Netlimicin-medium sensitivity was given and is currently under Amikacin vaccination for seven days (two per day). Please suggest is it fine or do we need to act upon further on? If so, please suggest medication.

Dr. Divakara P

Diabetology Endocrinology General Medicine Internal Medicine Pain Medicine Pulmonology (Asthma Doctors)
#

Hello,

Welcome back to icliniq.com.

Went through the reports of your father. (attachment removed to protect patient identity).

See the most common cause of small bowel thickening is tuberculosis. But another important cause is intestinal cancer. Without biopsy, we will not be able to differentiate between TB and cancer, as weight loss is seen in both the conditions. So I strongly advise you to get an intestinal biopsy and get analyzed HPE (histopathological examination) for TB and cancer. If it comes as tuberculosis, then he can be started on tab AKT 4 once a day for six months. But if it comes as cancer, you may have to consult an oncologist.

As of urine infection is concerned continue Amikacin injection the same dose, but give it for ten days and repeat the urine culture after completion of Amikacin. As of time taken to stop weight loss if it is TB within one to two weeks, it will stop and he will start gaining weight, but if it is cancer then it may take months.


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