Impact of TB Medication When Diagnosis is Not Tuberculosis: Key Insights

Q: Impact of TB Medication When Diagnosis is Not Tuberculosis: Key Insights

Hello： <br>1. <br>Every medication has potential side effects; however, if the medication is necessary for the condition and the side effects are acceptable, it should still be used. <br>Based on the information provided, the chest X-ray is likely abnormal with lesions, and there

If the diagnosis is not tuberculosis, what impact might the previously taken medication have on the body?

Two weeks ago, my child at home and my colleagues at the office started catching colds, and I couldn't escape it either—I also caught a cold! I experienced a runny nose, body aches, fever, and a mild cough.
After visiting the clinic and taking medication for three days without improvement, the doctor changed my prescription.
However, on the Saturday of the following week, I coughed up blood-streaked mucus and urgently made an appointment for a consultation.
The doctor said there were no abnormal sounds in my lungs, but I requested a referral.
At the larger hospital, they performed an X-ray and sputum tests, and over the next three days, they collected sputum samples for further testing.
The following week, two out of three sputum samples tested negative, while one showed a +/- result (value: 1.2/300).
The doctor mentioned there was a trace amount of bacteria but was uncertain if it was tuberculosis (TB), requiring a culture period of 2-6 weeks.
However, due to the X-ray findings, I was classified as a reportable case.
To be cautious, I sought a second opinion at a provincial hospital, where the doctor advised that if that was the case, I should start treatment with medication, as further testing would yield similar results.
Consequently, I have been taking TB medication for five days (including today).
During my follow-up today, I had blood tests and another X-ray.
My blood results were normal, except for one elevated T-Bilirubin level at 1.3 *H.
The doctor noted improvement in the X-ray, but it seemed too rapid, leaving me confused about my condition.
The doctor mentioned that the +/- value from April 12 indicated a very small amount of bacteria, and I would need to wait another two weeks for confirmation.
Nevertheless, to be cautious, I was advised to continue the medication.
I am willing to cooperate with treatment, as I have many relatives and colleagues around me, and I do not want to infect anyone.
However, I have several questions:
1.
If it is confirmed that I do not have TB, what impact will the medication I have been taking have on my body? The medication is quite strong, and I feel very fatigued after taking it.

2.
Since I have been classified as a reportable case, what steps do I need to take? What should my family and colleagues do?
3.
My office environment is poorly ventilated, and some colleagues are still coughing.
Should they also undergo testing? I returned to Taiwan to work from a clean country, but two colleagues had been working in Shanghai for an extended period before returning.
As a supervisor, I also need to arrange for improvements in the overall environment.
I would appreciate any advice you can provide.
Thank you!

Yihuo Ren, 40~49 year old female. Ask Date: 2006/04/22

Dr. Zhou Ziguang reply Pulmonology

Hello:
1.
Every medication has potential side effects; however, if the medication is necessary for the condition and the side effects are acceptable, it should still be used.
Based on the information provided, the chest X-ray is likely abnormal with lesions, and there are also abnormal findings in the sputum.
Clinically, a diagnosis of pulmonary tuberculosis is reasonable, but management should depend on the final culture results and clinical response (to decide whether to continue treatment).
From a public health and medical standpoint, if pulmonary tuberculosis is initially diagnosed, treatment can be started.
As for potential side effects, they vary from person to person, and monitoring of liver, kidney, and blood tests is necessary.
2.
Reportable cases must comply with medical advice (medication/testing), and health authorities will also send personnel for follow-up and epidemiological investigation.
3.
If the work environment has poor ventilation and colleagues are coughing, it is advisable for them to undergo testing (including chest X-rays).
Sincerely,
Dr.
Chou Tzu-Kuang, Attending Physician, General Internal Medicine

Reply Date: 2006/04/22

More Info

When it comes to the impact of tuberculosis (TB) medication on your body, especially when the diagnosis is not confirmed as TB, there are several important considerations to keep in mind.
1. Impact of TB Medication: TB medications, such as Isoniazid, Rifampicin, Pyrazinamide, and Ethambutol, are potent drugs designed to combat active TB infections. If you are taking these medications without a confirmed diagnosis of TB, you may experience side effects that can affect your overall well-being. Common side effects include fatigue, nausea, liver enzyme elevation, and gastrointestinal disturbances. In your case, the feeling of lethargy could be attributed to the strong nature of these medications. It's crucial to monitor liver function tests, as these drugs can cause liver toxicity, particularly in individuals with pre-existing liver conditions or those who consume alcohol. If your T-Bilirubin levels are elevated, it may indicate some liver stress, and this should be discussed with your healthcare provider.

2. Notification and Cooperation: Being classified as a reportable case means that public health authorities are involved in monitoring your situation. You should follow your doctor's recommendations regarding medication adherence and any follow-up tests. Inform your family and close contacts about your situation, as they may need to be screened for TB exposure, especially if they exhibit symptoms like persistent cough or fever. Public health officials may also provide guidance on how to minimize the risk of transmission in your workplace.

3. Workplace Environment: Given that your office has poor ventilation and some colleagues are still coughing, it is advisable for them to undergo screening for TB, especially if they have had close contact with you. TB is primarily spread through airborne droplets, so ensuring that your workplace is well-ventilated and that symptomatic individuals seek medical evaluation is critical. You might consider discussing with your employer the need for improvements in the office environment to enhance airflow and reduce the risk of transmission.

In summary, while the medications you are taking are essential for treating TB, their use without a confirmed diagnosis can lead to unnecessary side effects. It is vital to maintain open communication with your healthcare provider about your symptoms and any side effects you experience. Additionally, cooperating with public health guidelines and ensuring that your workplace is safe for all employees will help mitigate the risk of TB transmission. Always prioritize your health and the health of those around you by seeking timely medical advice and adhering to prescribed treatment plans.

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