Tuberculosis

Patient had been to multiple facilities with no clear diagnosis and lot of work up for other unrelated diagnosis.  (Sign of failed Healthcare System of America.. Lot of tests but no physician time that can save the patient from harm)

Patient presented to the clinic with complaint of cough and then during the discussion said "I also have swelling in the legs" . Physical examination revealed swollen lymph nodes and we saw that patient's earlier clinician(non-physician) missed the signs and instead diagnosed the swollen lymph nodes  as a  mass (it was not. It was  lymphadenopathy) and planned a biopsy and did that too (probably) with no conclusions.

Long story short we rescue the patients and we diagnosed active TB  in the very first visit itself and hence this post. 

First. TB is a preventable disease and, barring instances of extreme drug resistance, is 100% treatable. But making sure patient adheres to the treatment plan is the key.

Unlike other practices we focus on getting things right so we order Quantiferon gold test and only when required we order radiology tests to confirm. 

We have found that skin tests are prone to false positives due to earlier exposure to the TB disease. 

Once we have diagnosed, we make sure patient gets the best treatment at the Denver's best TB clinic and continue to monitor patient for all the primary care needs other than TB treatment. 

Symptoms of TB

Typical symptoms of TB include:

• a persistent cough that lasts more than three weeks and usually brings up phlegm, which may be bloody
• weight loss
• night sweats
• high temperature (fever)
• tiredness and fatigue
• loss of appetite
• swellings in the neck

You should see a Dr. Kamat if you have a cough that lasts more than three weeks or you cough up blood.

TB that affects the lungs (pulmonary TB)

Most TB infections affect the lungs, which can cause:

• a persistent cough that lasts more than three weeks and usually brings up phlegm, which may be bloody
• breathlessness that gradually gets worse

TB outside the lungs

Less commonly, TB infections develop in areas outside the lungs, such as the small glands that form part of the immune system (the lymph nodes), the bones and joints, the digestive system, the bladder and reproductive system, and the brain and nerves (the nervous system).

Symptoms can include:

• persistently swollen glands
• abdominal pain
• pain and loss of movement in an affected bone or joint
• confusion
• a persistent headache
• fits (seizures)

TB affecting other parts of the body is more common in people who have a weakened immune system.

Treating TB

With treatment, TB can almost always be cured. A course of antibiotics will usually need to be taken for six months.

Several different antibiotics are used because some forms of TB are resistant to certain antibiotics.

If you're infected with a drug-resistant form of TB, treatment with six or more different medications may be needed.

If you're diagnosed with pulmonary TB, you'll be contagious for about two to three weeks into your course of treatment.

You won't usually need to be isolated during this time, but it's important to take some basic precautions to stop the infection spreading to your family and friends.

You should:

• stay away from work, school or college until your TB treatment team advises you it's safe to return
• always cover your mouth when coughing, sneezing or laughing
• carefully dispose of any used tissues in a sealed plastic bag
• open windows when possible to ensure a good supply of fresh air in the areas where you spend time
• avoid sleeping in the same room as other people 

If you're in close contact with someone who has TB, you may have tests to see whether you're also infected. These can include a chest X-ray, blood tests, and a skin test called the Mantoux test.

Care Plan.

We work in Denver's TB Clinic to create an individualized care plan to treat and cure you.   Please talk to Dr. Kamat on what is your care plan and keep your follow ups with Dr. Kamat.