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Respiratory Disorders (Expert Forum)
Asthma_Node_TB
Answered by
This forum is for questions and support regarding lung and respiratory issues such as: Allergies, Asthma, Bronchitis, Colds - Flu, Chronic Cough, COPD, Cystic Fibrosis, Emphysema, Fibrosis, Lung Abscess, Nasal Polyps, Pleurisy, Pneumonia, Sarcoidosis, Sinusitis, Tuberculosis.
Asthma_Node_TB
by WorriedMom2, Aug 01, 2002 12:00AM
My daughter aged 6 years has repeated bouts of cold and cough since she was 3 and a half.2 years ago an Xray showed white patches in the lungs. this was treated as atypical pneumonia.Along with this Mantoux(negative) and phlegm check for 3 consecutive days (neg) were done.follow up xray after one month showed white patches again. then a Ct Scan was ordered which was done without contrast.This showed some consolidation (phlegm?) in the lungs and a hint of an enlarged lymph node in the neck.At this point we said no more scans. They did an ultra sound of the neck and did find a very small node. So the diagnosis was
1)the node was probably due to TB (common in india).TB which is localised in the node and not as an active infection(remember mantoux was neg and also phlegm never showed TB bacteria.)
2)The white patches were probably due to airways disease. A PFR also helped to confirm this.however she doesn't wheeze although once ina while (rarely)she does have a dry cough.
So she did 9 months of anti-TB (Rifampicin) and is also on inhalers.Periodic checking of the node via ultrasound showed taht it remained the same size.Now they say it is fibrosed or calcified (healed node?).
What do you think of this daignosis?Did she really need to take the TM med?Do we still ahve to keep checking the node?Does she need inhalers?I dont like these steroids.Her outward symptoms are getting colds and then sometimes ending up with pneumonitis.
Was all this necessary?
Dont know what to do really...
1)the node was probably due to TB (common in india).TB which is localised in the node and not as an active infection(remember mantoux was neg and also phlegm never showed TB bacteria.)
2)The white patches were probably due to airways disease. A PFR also helped to confirm this.however she doesn't wheeze although once ina while (rarely)she does have a dry cough.
So she did 9 months of anti-TB (Rifampicin) and is also on inhalers.Periodic checking of the node via ultrasound showed taht it remained the same size.Now they say it is fibrosed or calcified (healed node?).
What do you think of this daignosis?Did she really need to take the TM med?Do we still ahve to keep checking the node?Does she need inhalers?I dont like these steroids.Her outward symptoms are getting colds and then sometimes ending up with pneumonitis.
Was all this necessary?
Dont know what to do really...
Doctor's Answer
by National Jewish, Aug 06, 2002 12:00AM
, Aug 06, 2002 12:00AM
This is a complex situation. The first order of business is to determine the cause of the "repeated bouts of cold and cough" and the "white patches". A lung specialist for children, called a Pediatric Pulmonologist, should see your daughter.
It is very unlikely that the cause is tuberculosis (TB), common as it may be in India. The fibrosed or calcified lymph node could be due to TB, but that diagnosis should not be assumed. Since the lymph node is fibrosed and calcified, inactive disease is strongly suggested. Enlarged lymph nodes in the neck are common in children with frequent respiratory infections. As long as the node remains unchanged in size and appearance, nothing more needs to be done. Incidentally, a negative Mantoux test does not rule out TB.
Airways disease does not cause white patches on a chest x-ray. White patches may be seen on a chest x-ray when the airways disease is asthma and along with the asthma there is an allergic condition, called Allergic Bronchopulmonary Aspergillosis (ABPA).
With the information provided, I am unable to comment on whether the Rifampicin was needed. If there were no side effects, no harm was done by giving it.
You said, "Her outward symptoms are getting colds and then sometimes ending up with pneumonitis." Frequent respiratory infections and coughing can occur with cystic fibrosis or asthma. Cystic fibrosis is generally not treated with steroids. Asthma is generally treated with inhaled steroids. Your daughter’s diagnosis is what must be established. Only then can she be placed on the most helpful treatment.
It is very unlikely that the cause is tuberculosis (TB), common as it may be in India. The fibrosed or calcified lymph node could be due to TB, but that diagnosis should not be assumed. Since the lymph node is fibrosed and calcified, inactive disease is strongly suggested. Enlarged lymph nodes in the neck are common in children with frequent respiratory infections. As long as the node remains unchanged in size and appearance, nothing more needs to be done. Incidentally, a negative Mantoux test does not rule out TB.
Airways disease does not cause white patches on a chest x-ray. White patches may be seen on a chest x-ray when the airways disease is asthma and along with the asthma there is an allergic condition, called Allergic Bronchopulmonary Aspergillosis (ABPA).
With the information provided, I am unable to comment on whether the Rifampicin was needed. If there were no side effects, no harm was done by giving it.
You said, "Her outward symptoms are getting colds and then sometimes ending up with pneumonitis." Frequent respiratory infections and coughing can occur with cystic fibrosis or asthma. Cystic fibrosis is generally not treated with steroids. Asthma is generally treated with inhaled steroids. Your daughter’s diagnosis is what must be established. Only then can she be placed on the most helpful treatment.
