Dr. Nageswara Rao
Diabetology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
I am a 45-year-old female. I am getting on and off cough. I have lost 11.02 Ibs in the last two years. My CT shows atypical changes and the QuantiFERON TB test shows positive with a reading of 0.38. I am waiting to get my sputum test result. I am currently on Doxycycline 100 mg per day and this is my second course. I have mild breathing difficulty on exertion and have bilateral apical pleuropulmonary thickening and scarring along with apical pulmonary infiltrates. What is my actual diagnosis?
Hi,
Welcome to icliniq.com.
As per your symptoms, pulmonary tuberculosis has to be ruled out. Weight loss of 11.02 Ibs in two years is not significant. But, on and off cough with breathlessness is significant. QuantiFERON TB is not a diagnosis of active TB, It shows latent TB.
Your CT findings (attachment removed to protect patient identity) favorable to pulmonary TB, maybe some healed lesions. From your sputum results you can get a definitive diagnosis. You can try empirical antituberculosis treatment also.
Patient's Query
Thank you doctor,
Currently, I am taking Doxycycline and sent a sputum sample. Does this affect my accuracy of sputum report? If my sputum result shows negative, then do I need treatment?
Hi,
Welcome back to icliniq.com.
Doxycycline will not affect the accuracy. Even if sputum samples are negative and still you have symptoms, then you may need empirical therapy.
Patient's Query
Thank you doctor,
I had a whooping cough test positive. That time I had a persistent cough with a whoop sound ending and was treated with Azithromycin. Can whooping cough cause lung changes such as scarring, pleural thickening and infiltration? Now my cough stopped and when I touch it, both rib cages feel pain. I feel this pain for more than 5 years. Sometimes, I feel some inflammatory pain. When I asked to my GP, he said I am a bit skinny. He advised me to use some soft pillows when I sleep. I had a history of bronchitis two to three times. I think that this might result in muscle pain. I still have that pain on my both sides. What type of pain is it? Please let me know the causes. Do I need to get isolated from my family for my current situation? Please let me know if I need isolation. My cough settled with two courses of ABS Doxycycline. Sputum stopped only producing sticky mucus with a salty taste always. When I get up in the morning I can see some yellow color sputum.
Hi,
Welcome back to icliniq.com.
If sputum positive to TB bacilli, then only you need isolation. Otherwise, no need of isolation and wearing facemask for one to two weeks is sufficient. Whooping cough may or may not be the cause of apical lung changes. Your CT scan shows healed lesions.
Patient's Query
Thank you doctor,
My three samples of sputum AFB came as negative. My specialist checked my CT film and said there is mild changes. My doctor advised me repeat AFB after 6 weeks. They did my all blood test today and will review after 6 weeks with all the results.
Hi,
Welcome back to icliniq.com.
It is good that AFB is negative. As I said CT findings looks old lesions (fibrotic). Some infiltrates are also there. So, we need to rule out active disease. You can wait for culture report. It will take minimum 3 weeks. No need of isolation now. Continue the medication and complete Doxycycline course.
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Diabetology
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