Tuberculosis

[KKCAL]

About more than 13 years ,spine doctor started Tuberculosis treatment after seeing spine-lower part, but I did not started treatment, does this is normal that during this period TB has been settled or spread to other organs.
5-6 month back CT shows lung nodule size 5mm, catching infections frequently. Now doctor ask for chest XRAY,
Please guide that this is possible that I develop TB signs slow and slow during this period. Today X ray was done.  

[KKCAL]

Thanks, for your guide.

[mkh9]

Thanks, then why do I feel dumb? LOL.  Are you going to follow up on why your thyroid, growth hormone and vision are off? I would get that checked too with a MRI of the brain when you can. You need to rule out Pituitary tumor. If that is ok they need to adjust your thyroid and growth hormone levels anyway.
take care,
mkh9

[KKCAL]

Yes, you are correct, hope they will listen. You carry tons of knowledge.

[KKCAL]

On 26/04/2013- CT reads it shows incidental right upper lobe 5 mm pulmonary nodule, anterior segment.The bilateral faucial tonsils demonstrates moderate volumetric prominence with internal punctate calcifications compatible with chronic inflamation.which effectivly narrows the upper propharyngeal airway by approximately 80% on supine position.mild lymphatic prominence to the lingual tonsils with approximately 60% luminal narrowing
On 10/05/2013-No change in size of subpleural nodule within anterior aspect of right upper lobe,this again measure 4mm. Minor streaky bibasilar atelecttasis is present,no pleural or pleural space desease, no endobronchial or endotracheal abnormality.
Stable indeterminate 4 mm nodule .
No acute abnormality or findings to suggest malignancy.
You can please guide for what does mean-Minor streaky bibasilar atelecttasis is present,what does mean to stable nodule?
In lung function test 31/01/2013 it shows-
increased smaller airway airflow obstruction,FEF 25-75 is significantly decreased ,results suggest some small airways reactivity fits with history of ashthama.they mention that we can not exclude possibility of Episodic Bronchospasm.

Guide further. does findings CT scans and LFT  are a matter of concerns.
Chest Xray done in 2010 shows lung volume are slightly decreased.  accounting to this the cardiac sllhouette appears slighly enlarged. Minor linear ateleclasis or parenchymal scarring is identified in the right middle lobe.no soft tissue bony abnormalities are seen. Mild cardiomegaly, without evedence of pulmonary edema,
Minor subsegmental atelectasis or parenchymal scarring in the right middle lobe.

  

[mkh9]

How long ago was the CT positive for the nodule? The Quantiferon gold test would rule out whether you really have been exposed or not to TB. The Xray only tells you if it is active the Quantiferon gold tells you if you still have it in your body somewhere and it is latent.
mkh9

[KKCAL]

What are expectations - from lung nodule 5mm, does this may be TB related infection, X ray  chest ruled out TB,
guide what can be done for Nodule-

[KKCAL]

Thanks. trying to get hold of actual and real cause of health concerns but dont know when I will able.regards

[caregiver222]

In general there are at least three ot four and sometimes more drugs provided for treatment of tb. You must take EVERY one of them in accordance with the protocols, and still have a chance of pregression.  This rough because they tend to have side effects, and some people are allergic to them.  George Orwell, who died of tb, was one of the first to be treated with erythromycin, and he turned out to be alergic to that antibiotic. The bacteria mutate readily and new strains are exceedingly resistant to treatment. The absolute worse thing to do is to stop one of the drugs. Isoniazid is an interesting drug. Three drug companies developed it simultaneously and got into a patent fight, each acusing the other of strealing its research, only to discover it was invented fifty years before they "discovered" the process of manufacturing it in 1912 by a chemist as part of a Phd. disertation and thus "known in the art". Of course he didn't know it would treat tb. As mkh9 stated, multi-drug resistant tb is making a comeback. The disease has it's ups and downs and many patients feel better, have a remission, and cease taking the drugs. One of the problems is that the bacteria encapsulate themselves in a waxy bio-film that defies interaction with an antibiotic.

[mkh9]

Ok, let me know how it goes.
mkh9

[KKCAL]

Thanks a lot,Being in Calgary health system is like magic of confusion,specialists are bothering to proceed with protocol at all.
Will work as per directions of your good self and caregiver222.will keep on update you.regards

[mkh9]

If you still have the lung nodule you could still have active TB. If not then lets see if your quantiferon gold test indicates whether you have been exposed or not. If yes you may want to take Isoniazid for about 9 months so that you don't convert to TB in the future. If the nodule is not TB then of course you may want to find out if it is something else by getting a biopsy. If it is gone that is great. But all your symptoms are pointing toward TB. So, I would maybe double check that lung result. If the lung nodule is there you would want to get a sputum sample to see if you are active TB. Then you would have to take the 4 antibiotics for about 3 months. If it is gone it seems strange and you may want a second opinion. Caregiver222 has some good points in that some strains of TB are super resistant  to antibiotics and thus untreatable. But a lot of strains are treatable and so we just have to wait and see what is going on. If you do have TB you need to get treated right away. My mother had TB and my brother's dad. I am a clinical microbiologist and keep up on the latest. In San Diego, California we have 20% multidrug resistant TB and we are not one of the higher resistant areas but we are near the Mexican boarder so we get a lot of immigration here. In any case, do pursue this soon.
regards,
mkh9
mkh9

[caregiver222]

I spent a year researching tb, and it is a nasty and fatal disease. The new varieties are resistant to traditional drug treatment. It can and will spread to every part of the body, including the brain, and has the potential to be contagious and infect all around you. A Bath shipyards in Maine a single tb infected worker infected 356 others. You need to go to a specialist in tb and religiously follow the drug protcols, which is very hard to do. You can never be cured of tb. It can only end up in remission, and the longer you delay in treatment the less likely of a good outcome.

[KKCAL]

Thanks, you carry superb knowledge, will ask family doctor for this test.Dont know lung nodule disappear or not, will try to get CT scan as mentioned on last report of CT that follow up CT in 6 months is required. For fever on times body gets warm, all time tired,weak, strength is like zero.

[mkh9]

Hi, well that is good that the Xray and CT was negative. Have you had the BCG vaccine? You may want to get the quantiferon gold test to determine if you have had exposure to TB though. It won't show up on an Xray but you could still have been exposed. If it comes up positive you may still want to get preventive treatment with INH. Aside from that did the nodule on the lung disappear? Do you have any other symptoms such as cough or fever etc.
mkh9

[KKCAL]

TB doctor ruled out TB, He check Xray, CT also, no skin test was done. pain in center part of head. lower back spine pain.

[KKCAL]

Thanks, Today going to see TB clinic.will update request to you,

[mkh9]

You should get treatment for the spinal TB because you can lose use of your legs. TB grows very slowly. You may have been reinfected with TB and it got into your lungs. Did you get the results of the Xray yet? If it is positive you need treatment with 4 antibiotics for about 3-4 months. You must stay on them even if you get sick because the TB can become resistant if you don't.