"List of other diseases, conditions, or
injuries and their treatment: Conditions
in Jan 2007: Shortness of breath, need for
deep breaths often, discomfort / pain in
the left lung region, loss of weight
(around 6 kg in a short duration), night
sweats. coughing, throat irritation /
infection, fatigue upon slight exertion,
fast / irregular heart rate.
Diagnosis that has been suggested: I was
diagonised with Tuberculosis in Jan 2007.
Preliminary examinations also pointed out
a presence of fluid in the left lung. A
portion of the fluid was removed by
Thoracentesis. It was tested for cancerous
cells and that test came out negative.
Also, thyroid tests were normal. Heart
pulse rate was around 125 beats/min. ESR
was around 61 mm / hour. A CT scan done in
May 2007 pointed at Empyema in the left
lung.
Current medical status: After taking the
TB drugs for around 7 months, I am feeling
a little better but am not completely all
right. The pus / fluid in the left lungs
has lessened by about 30%. Fatigue still
overcomes me upon activity. There is a
shortness of breath, the feeling of a
"pull" in the left lung sometimes.
Occasionally night sweats as well.
Current medical treatment: Initially (Jan
2007) I was started on Rifampin,
Isoniazid, Pyrazinamide and Ethambutol.
Along with this, a 25 mg Vitamin B6
supplement was given. Corgard for
tachycardia / arrhythmia. After 2 months
of drugs, the drug sensitivity tests
showed that the bacteria was PZA
resistant. So I was asked to cut down on
that and continue on the other three.
Interestingly as soon as I left PZA, the
symptoms started relapsing and increasing
steadily. When I resumed PZA the symptoms
started going down again. I am positive
this is not coincidental as this has
happened twice since. When I told my
doctor about this incident, my doctor
asked me to stop PZA and start on
Streptomycin injections biweekly. My first
dose caused a little headache, a quivering
/ numbing feeling around the lips and a
drowsy feeling throughout the day. I am
yet to take my second dose (due later
today). However, stopping PZA has once
again started increasing the symptoms
slowly."
If the bacterium is resistant to PZA, then
the antibiotic was not effective. It is
very strange in your case, however, that
excluding an ineffective antibiotic made
the condition worse. It seems likely that
your condition is not worse but you only
think that symptoms became worse. The
symptoms that you are experiencing
(shortness of breath, need for frequent
deep breaths, discomfort / pain in the
left lung region, night sweats, coughing,
throat irritation / infection, fatigue
upon slight exertion, fast / irregular
heart rate) are more subjective than real
and may not be due to tuberculosis. A real
evaluation of tuberculosis can be achieved
via a microbiological examination of the
sputum, a chest X-ray image, blood
analyses with sedimentation rate (ESR) and
skin tests (tuberculin-test).
We can say that a tuberculosis is
worsening if the infective agent bacterium
"Mycobacterium tuberculosis" is isolated
in the sputum again, if the lung lesion is
expanding, if sedimentation rate is
increasing or if the tuberculin-test on
the skin is more positive than previously.
The opposite findings would indicate that
the infection is getting better.
Mycobacterium sensibility or resistance
can be tested by isolating the infective
agent from the sputum and antibiogram.
Urine color should not be your primary
concern now.
Tuberculosis - how to determine the level
of infection ? Is bacteria resistant to
new drug?
DISCLAIMER: "Ask a Doctor" Questions are answered by Dr. Nikola Gjuzelov, General Practitioner. Dr. Gjuzelov practices medicine for the general public and is affiliated with the Republic of Macedonia Public Health Institution. For more information about Dr. Gjuzelov or other eHealthForum.com medical experts, please visit our About Us page. You may also visit our Tuberculosis Forum, for moderated patient to patient support and information.
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