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Avatar universal

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Hi all..I am 27yrs male...I have a habit of smoking..past 10 days I am having high fever..I have taken some tests in which
Lymphocytes and eosinophills are bit higher than the upper limit of range.
I have taken tb skin test which turned out positive with 20mm*20mm
In chest xray it states as increased branchovascular markings and pulmonary conus appear prominent.
But my doctor says he is not sure of tb..
Am scared wat will be my problem.
11 Responses
1415174 tn?1453243103
COMMUNITY LEADER
Hi, Welcome to the Infectious Disease Forum. We are not doctors on these sites. However, I am a microbiologist and can give you some advise. How high has your fever been. In adults a high fever is about 101-102 degrees F. Also, if your lymphocytes and eosinophils are in range they are normal, it doesn't matter if they are on the high end or not. Have you had the BCG vaccine in the past? That could cause a positive TB skin test. If not you could have been exposed to TB in the past or present. The Xray is hard to know. The smoking maybe could cause the markings or infection or something else. I don't know about the conus.

What country do you live in? Can you get a quantiferon TB blood test? That will give you a result that states if you are currently positive for TB. Also you can get a TB sputum culture done. It takes a while for results for the culture . They should do it a couple of times on different days. If you do the culture you have to cough up a deep cough not just spit.

Do you have night sweats, a cough especially a cough with blood or pink or rusty looking?, weight loss?, low appetite?
If not you may just be carrying the bacteria also and not active. If not active you can go on one antibiotic usually Isoniazid (INH) for a period of time and it will kill the bacteria before you get sick. If you are actively positive then:

Then if positive you have to go on several antibiotics for several months and stay on them whether you feel sick or not. Unless you are allergic of course then  you may be able to switch to a different one. But they use 3 because they don't want the bacteria to become resistant or if it is resistant to make sure you get cured. But lets hope you don't have it. If you come up positive i can help you understand what the doctor says about treatment.if you need that.

So let me know if you have any other questions.

Take care,
mkh9

Avatar universal
Hi mkh9,

Thanks a lot for the reply

I am from India and I haven't taken any BCG vaccine before. I have given sample for quantiferon TB gold test today and I hope I will get the reports on Saturday.
One more thing is I don't have cough to go for a sputum culture.
Yesterday I have taken HR CT chest(contrast)and ct abdomen and pelvis (contrast) which came out as everything is fine...
I am planning to take immunoglobulin panel test (IGA,IGM and IGG)..will it be helpful in diagnosing my problem.
I have been diagnosed with high cholesterol and vitamin b12,D and folate deficiency..
Do you thing is there any disease in me which is leading to all these deficiencies, because I always take a healthy diet but still don't know why it turned out deficient.
My doctor has prescribed me doxycycline antibiotic for 21 days and he is said its a antitb drug.
My doubt is if the infection is because of tb , will this drug make the bacteria drug resistant.
3 Comments
Sorry forgot to ask one question
...is there an test which tells whether I have active tb or inactive tb???? If yes kindly let me know the name
Yes the quatiferon gold test tells you both if it is active and/or inactive TB. So if that is positive you should get a sputum culture done as I mentioned. If you don't have a cough maybe the doctor can explain how to produce one.  Good question.  If you can cough up something (besides spit), they can do culture and molecular studies if it is positive. That will come up faster than just culture if they will do it. Either way if you have inactive it is good to get just the one drug to prevent getting active TB if it is active then you need the full treatment. If you don't have cough, night sweats, fatigue and/ or low grade fever you may just have inactive.

If the doctor thinks by your symptoms it is inactive they will just treat you for that with probably isoniazid (INH). Ask them if your family needs to take it too. I am not sure about this.

It sounds like you may be iron deficient possibly. Have you had your blood tested for iron? Are you vegan ? If so or don't eat much meat?you could be anemic especially since your B12 is low.  You can take sublingual (under the tongue) B12. The best type is methylcobalmin 5000 IU once a week. But if the doctor thinks you are very low they can give you an injection to start with. Also, if you are a woman you can bleed too much from a menstral period and become anemic if you are a man or women you can also bleed from an ulcer, hemorrhoids  or other area and this can cause anemia. some medications can cause it too. If your complete blood count shows you are anemic and/or the iron test low iron you can take iron pills but you have to be careful not to take too much. So follow the doctors advice on this and get your blood tested before taking iron and test every few months because you don't want to get too much iron it is hard to get rid of when you get too much.

No the doxycycline shouldn't change the resistance of tuberculosis as it doesn't work on that bacteria at all.

The immunoglobulin tests won't diagnose TB (igA, IgG etc).

mkh9
p..s. are you or have you been on any TB drugs? These antibiotics can be hard on the stomach and intestines? mkh9
Avatar universal
Hi mkh9

Thanku for the support.

I am a male.I have fever always from 15 days ..it goes down when I take medicine but comes back again. Anyways I will get back to you with my quantiferon report once I get it.
Yeah my doctor has prescribed me methycobamalin injections for B12 deficiency and asked me to take them weekly twice.

Last question is TB curable?? Is it one time treatment or should I take always in my life time.
3 Comments
Yes TB is curable. Although a very small percentage like  a few in the world are resistant to all antibiotics. But they can do other things instead. So try not to worry.
mkh9
Also, there is about a 2 month or so treatment then you are cured.  I can give you details if needed. But Of the top of my head it is a combination of 3 antibiotics and then you get rechecked. to see if you are still positive. If you are just exposed from the past you are just given one antibiotic (INH) as I explained above for about 1-2 months and that is it
mkh9
If the culture happened to come back after treatment still positive (if you were positive to start with ) this is hypothetical, then they might extend antibiotics and retest. Do you see what I mean?
regards,
mkh9
Avatar universal
Hi MKH9

Today I got my quantiferon TB gold report which came out as positive...

Results are as below..

Gamma interferon antigen tube - >10 IU/ml

Gamma interferon NIL tube - 0.15 IU/ml

Interpretation

| NIL TUBE in | ANTIGEN TUBE | FINAL RESULT | INTERPRETATION |
| IU/mL | MINUS NIL TUBE | | |
| | in IU/mL | | |
|-------------|--------------------|------------------|------------------------------------|
| < = 8.00 |  = 0.35 &  = 0.35 & > = 25% | Positive | M. tuberculosis infection likely |
| | of Nil tube | | |
|-------------|--------------------|------------------|------------------------------------|
| >8.00 | Any result | Indeterminate | This may be due to excessive levels|
| | | | of circulating gamma interferon or |
| | | | presence of heterophile antibodies
Avatar universal
Hi MKH9,

Here the is the complete detail of me. Request you to go through it and suggest me accordingly

Fever and chills from past 13 days

Mantoux test - positive 20mm

High(not too high) eosinophills and wbc

X ray PA view (increased branch vascular markings )

Ct chest, abdomen and pelvis (Contrast) - no findings

Vitamin deficiency (Vit D,B12,Folate)

High cholesterol (LDL & triglycerides)

Quantiferon TB gold test - Positive

Antigen tube - >10 UI/ml
Nil tube - 0.15 UI/ml

I am feeling some what better after taking the medicine (Doxicycline) prescribed by GP.

My doctor still says he cannot make sure of TB in me..and he says quantiferon gives false positive .

Am very confused what to do now..should I start my treatment of TB or should I go further testing...

Kindly suggest me...


1 Comments
My advice is that since your regular TB skin test was positive (20 mm) and you didn't ever have the BCG vaccine and then the quantiferon gold test was also positive that you try to get a sputum culture done. If you doctor doesn't want to persue this you should see an infectious disease doctor It could be either a past infection most likely or a current one. I can't read Xrays so you would have to talk to them about the results. It is hard to tell sometimes from Xrays too because it can also be past exposure. But,since you have symptoms of fever it sounds like you need to be treated. in addition, you have a anemia or vitamin deficiency that needs to be handled. So keep on top of that separately. I would think that the chest Xray would have shown something of the spine? But a MRI or CT would show more. You can get TB of the spine and other areas. Since you have back pain and fever and positive TB skin test it could be past infection or    possibly present. So if you can bring these issues up with an infectious disease doctor. They are better at putting things together like this. It is up to you if you can afford to get the MRI or CT's done to rule them out. But I'm sure they are costly. Why don't you see what the ID doctor says. But I wouldn't let it drop. I think you should be treated at least with INH (isoniazid) for an exposure but the thing is you need to find out if you sputum culture is negative. You need to do more than one. Maybe the doctor can assist you somehow with collecting one. If you really are positive in the lung or other area you will need other treatment besides doxy. Does this help?
Regards,
mkh9
Avatar universal
I have gathered some information by surfing in the internet and imagining like I may have infection like spinal tb or brain.
The reason for assumption is I have back pain and neurological symptoms. Do I need to under go a MRI or CT for head and spine or do you suggest me some other test for identifying tb in spine,bones and brain.
Avatar universal
Hello MKH9,

Am waiting for your reply...please assist me..one lasts question is there any test which can differentiate between tb bacteria and other bacterial infections?
2 Comments
See comments above.
mkh9
Also, from the CDC:People with TB disease usually have symptoms and may spread TB bacteria to others.
Woman coughing into arm

A cough lasting 3 weeks or longer is a symptom of TB disease.
TB Disease: Only the Tip of the Iceberg

People with latent TB infection do not have symptoms, but may still need treatment.

TB bacteria most commonly grow in the lungs, and can cause symptoms such as:

    A bad cough that lasts 3 weeks or longer
    Pain in the chest
    Coughing up blood or sputum (mucus from deep inside the lungs)

Other symptoms of TB disease may include:

    Weakness or fatigue
    Weight loss
    No appetite
    Chills
    Fever
    Sweating at night

https://www.cdc.gov/features/tbsymptoms/index.html

You still have to prove it is active TB by culture, or other means you can discuss with a good infectious disease doctor. If it isn't (No symptoms) Like I said you should treat it anyway with INH. But talk to the specialist.
Regards,

mkh9
Avatar universal
Hi mkh9

Thanku for the support ...I will get back to u with my doctors opinion
1 Comments
Okay thanks.
mkh9
Avatar universal
Hello mkh9 ,
This is Snxyr66 ..sorry for texting from another profile as my previous one is not accessible..

As u know about my previous medical history..I have taken TTg IGA test which came back as positive ...j have extreme bloating , abdomen pain and diaohrrea and burning sensation in stomach from past 5 days..doctor says am celiac but my parents nor anyone have it..how should I confirm am celiac..does taking endoscopy and biopsy of small intestine rule out both tb and celiac disease...one more doubt is does tb leads or in any way will tb be a cause for celiac disease???
1 Comments
No TB shouldn't cause Celiac. Gluten intolerance causes it. So you have to eat NO Wheat gluten in any food. See if that makes your symptoms go away.
mkh9
Avatar universal
Please suggest me the tests for celiac confirmation..and will I die soon with this disease please let me know because I have some responsibilities of my parents which I have to complete...
3 Comments
https://www.mayoclinic.org/diseases-conditions/celiac-disease/symptoms-causes/syc-20352220

    Serology testing looks for antibodies in your blood. Elevated levels of certain antibody proteins indicate an immune reaction to gluten.
    Genetic testing for human leukocyte antigens (HLA-DQ2 and HLA-DQ8) can be used to rule out celiac disease.

If they have an antibody test try those.
mkh9
If they don't have these tests you can try the gluten free diet for 6-12 months.
mkh9
Avatar universal
I will get that test done and get back to u....one more thing is does intestinal tb will cause celiac disease...
4 Comments
I never heard of intestinal TB. If you had it (theoretically) I don't think so. Only gluten intolerance causes it.
mkh9
Also, antibiotics can cause intestinal problems by their side effects, also they disrupt normal bacteria numbers. So if you are finished taking the antibiotics you can take probiotics. Get live bacteria that are probiotics such as lactobacillus sp. bifidobacteria sp. Another thing is if you have diarrhea such as going having diarrhea 10 times a day or more with bad cramps etc. then you could have Clostridium difficile. You can get this from taking antibiotics and since they disrupt the normal gut /intestinal bacteria then you can get it if you have been exposed to it. You can get tested for it but only if you have severe diarrhea. Hope this helps.
mkh9
Do u have any idea about whipple disease and also can u suggest me wat tests can diagnose it??
Have you been diagnosed with it? If so this is a good link. But one treatment  it mentioned is plaquenil. Don't ever take this drug. My best friend went blind from it and my other friend had serious bleeding from it. It is sometimes also used for lupus. It is not a good drug. I wouldn't let someone talk me into taking it. That is my opinion.

https://www.mayoclinic.org/diseases-conditions/whipples-disease/basics/treatment/con-20025442

mkh9
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