TB or not

[Super_sally888]

Hi,

I am 37 yo active australian living in Philippines.

I have had some problem with feeling tired a lot lately (even when I sleep a lot), also have hard lymph nodes in my neck, and some strange burning sensations - particularly on my back and legs, I often feel really hot, but my hands are freezing cold and my body temperature is low normal. Some weird visual symptoms too, flashing lights in peripheral vision and sensation of moving objects.  Base of skull headaches frequently.  Checked by neurologist/eye dr. but nothing was found wrong.

My other doctor did skin test for TB.  It came back positive. 27mm.
But chest x-ray and sputum test are all negative.

I am reluctant to start antibiotics of INH for nine months if I don't really have TB.

Could this just be stress related and nothing physical at all.  Or should I consider taking the TB meds.  Should they look further?

I have hypothryoid (treated with T4), celiac, asthma, and food & environmental allergies (but can't work out to what yet... cause they are inconsistent...).  Have stopped all antiallergy / asthma / vitamin supplements/ meds 10 days ago now in case these are contributing to what I am feeling.... so far not much improvement & asthma/allergy symptoms are recurring.....

Any advice / input would be very welcome.

Thanks

[Super_sally888]

Hi,

Thanks for your answer.

If you do decide to try INH, you could make sure you have liver test before you start and then test again after a couple of weeks.

I was reading up on the liver effects and it seems it was only ever fatal in people who kept taking the drug even when they developed symptoms of liver problems.  So the key is to recognise liver problems, if ever early, and stop the drug immediately.

However, I think with 10mm induration and no symptoms / clear chest x-ray observation might be a good option.

I don't know if that blood test you mentioned is availalbe here.  Will check it out when I get back from travelling.

Best wishes,

Sally

[nickip]

Hi,  

I am 39, and going through a similar decision.  As part of a routine screening for entering nursing school, I came up borderline positive for TB with a two-step skin test (where they do a repeat test a week later).  I find it really hard to believe 100% that I am carrying TB, although I traveled overseas a lot, and actually lived in the Canary Islands for seven years.  I say borderline, because the lateral measurement both times was 10 mm.  Chest x-ray was negative.  

I don't know if this helps you or makes things worse, but if I had had a 27mm induration, I'd feel a lot more secure that it was a definite positive.  Have you asked about getting the QFT?  It is a blood test that has a completely different way of detecting immune reactions to TB from the skin test.  I would wait some amount of time (maybe a month?) before doing this test, if you did the skin test recently, because I have read that the dead TB particles in the skin test might affect the results of the QFT.  

As for whether or not to take the isoniazid, I also am in a quandary.  I am terrified of putting my liver at risk from this drug, but the thought of developing active TB is also scaring me to death.  I have three small children.  The truth of the matter is that I have a far higher chance of developing active TB in my lifetime than having liver failure.  And the older you are when you do isoniazid treatment, supposedly the more likely you are to have liver reactions to it.  

So, I know I've been no help - just thought I'd let you know someone on the other side of the world was going through something similar.  Good luck with whatever you decide.