Is it fine to start TB treatment before test result comes?

Hi,

Welcome to icliniq.com.

I went through the reports and prescription (attachment removed to protect patient identity). From the report he has a decreased renal function with increased serum creatinine levels as well as urinary infection seen as increased pus cells. Whenever the culture is negative we have to presume that urinary tract tuberculosis is a possibility. Let us wait for the AFB culture (acid-fast bacteria). I would better suggest urine PCR (protein creatinine ratio) for tuberculosis; three early morning samples to be collected before starting on anti-TB drugs (anti-tubercular). He can be given anticholinergic drugs like tablet Tolterodine (Tolterodine tartrate) as well. I need to know the previous USG (ultrasound sonography) scan report, which is done before kidney stone removal to look for the bladder capacity.

Hi,

Welcome back to icliniq.com

I went through the old reports (attachment removed to protect patient identity). He had ureteric as well as renal calculus which was cleared. The present symptoms are not related to the stone disease and are suggestive of urinary tract infection in the bladder. Since the urine culture report is negative we have to think and evaluate for urinary tract TB. This particular disease is difficult to diagnose. Options left are urine AFB culture and Urine PCR for TB. However, anti-TB drugs based on symptoms alone is not advisable. We start ATT (anti-tubercular treatment) only after a laboratory evidence of the same. Anti-TB drugs do cause gastritis which could be the reason for vomiting, for which you can add tablet Pantocid D (combination of Pantoprazole and Domperidone) twice a day before food. Regarding the anti-TB drug kindly consult your surgeon whether to continue or to withhold till the AFB results are available.