My mother is 48 years old. She used to suddenly get cold, headache and fever very often. We are unable to find the exact reason. We have done some tests for her, which I am uploading here. Please go through them, and let me know what may be the reason? And also let me know what remedy should be taken. Thank you.
Welcome to icliniq.com. I have gone through your query as well as the reports (attachments removed to protect patient identity) and can understand your concern for her health. Repeated attacks of fever, cold and headache can be due to repeated infections of the body which could be viral or bacterial. Low resistance to infections or low immunity of the body can cause repeated infections. The values are within normal limits except erythrocyte sedimentation rate (ESR). A high ESR indicates chronic infection in the body like tuberculosis or autoimmune disease or granulomatous diseases or connective tissue disorders. These conditions also lower the body immunity. In my opinion you should consult a physician and she needs proper work up to rule out these diseases. I am not saying that she has tuberculosis. Tuberculosis is the commonest disease causing high ESR. She should undergo proper investigations for that such as chest x-ray and Mantoux test. Another reason for repeated attacks of fever, cold and headache can be allergy also. So, if she develops these symptoms after exposure to certain allergens or allergy causing substances, ask her to avoid them. For low immunity, she can take high protein diet like pulses, sprouts, egg white, etc. Citrus fruits like lemon, gooseberries, oranges also boosts immunity as they contain vitamin C which makes the immune system strong. Proper nutritious diet also helps. Along with all these, she can take Vitamin C tablets also daily once.
As per your suggestion my mother had gone through the test. Mantoux test has come back positive. Is it a matter of concern? Her chest x-ray reports are yet to come. Please suggest the next step. I have attached the test report for your reference.
Welcome back to icliniq.com. I have gone through the report (attachment removed to protect patient identity). It is strongly positive. There is tuberculosis infection in her body. She may need treatment depending on chest x-ray report. My suggestion is that you should consult a physician and show the chest x-ray. Then the physician will decide regarding treatment of tuberculosis.
I am attaching the x-ray report and along with other reports. The x-ray report seems fine. Please suggest the next course of action.
Welcome back to icliniq.com. I have seen the reports. X-ray is normal. The treatment cannot be started only depending on a positive Mantoux test as the x-ray is normal. Also her repeat ESR is only slightly high and lymphocyte count is normal. Generally, in the case of active tuberculosis, there is an increase in the lymphocyte count. A positive Mantoux indicates that there is an infection in the body, but it does not mean that the patient has the disease. Infection by non-tuberculous mycobacteria can also cause a positive Mantoux test. As her chest x-ray is normal, I think there is no need for starting treatment for tuberculosis at present. If her fever, cold and cough keep on recurring in future, you can do one CT scan of the chest in future.
Thank you. So, what to do now? She will suddenly get cold and fever. Is there any precaution to be taken? Since x-ray is normal what can be done from our level so that she does not get cold and sick? You said that infection is there, so could it be a matter of concern in future?
Welcome back to icliniq.com. Positive Mantoux means that the body is infected by mycobacteria, but it can be tuberculous or non-tuberculous. It does not mean that the patient has the disease. The test is not specific for tuberculosis. If it is positive and there is evidence of disease in the body like in the form of positive x-ray or presence of cough with sputum positive for TB or presence of lymph nodes in the body, then treatment is required. You follow the instructions which I have given in the first reply. Avoid exposure to cold and take proper diet to increase the immunity. CT scan of the chest and abdomen will show if there is any active infection in the body or not. If you want you can do one CT scan of the abdomen and chest in future if her symptoms persist. Repeat Mantoux test, ESR (erythrocyte sedimentation rate) and differential count after eight weeks. In my opinion, she does not need treatment at present.
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