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	Specialist Answers
Question Category : Tuberculosis
Can a 5 years old male have left conjugate gaze palsy involving left MLF, with simultaneous UMN type of facial nerve palsy as a complication of TB Meningitis? If SO ,kindly explain the mechanism. Check Out the Answer
Question Category : Tuberculosis
What are advantages and disadvantages of tween-80 in PPD for tuberculin test? Check Out the Answer
Question Category : Tuberculosis
This is regarding anti-tubercular therapy. We have been taught that pyridoxine supplementation is not required in children when they get INH. But nelson has mentioned that pyridoxine may be required to be supplemented in 1-HIV infected children 2-Breast fed infants 3-children taking inadequate diet, if we consider these facts then a significant number of pediatric patient will require pyridoxine. Whereas none of the above said children we have prescribed pyridoxine. Kindly clarify. Check Out the Answer
Question Category : Tuberculosis
Hi doctors Recently my son who is 4 years old did a test called " Antibody to Tuberculosis - IgM", and the result was Equivocal( 0.96 units ). I am worried whether he has TB , my family and in-laws family no one has detected TB , doctors please let me know whether this is curable I am bit worried and tensed, what precautions do I need to take , also I have a 6 months child , whether he also can get this disease . Also for my 4 yr child I did one more test today called as " MT " , I have to wait for 2 days to see the reaction and then I would come to know . What precautions do I need to take , I want to give my son the best and want to sure the same , please help doctors. Also did a CBC test (WBC count is more it is around 27,700 cell/Cu.m H). Doctors please advice and let me know how can I cure this disease" Tuberculosis". Check Out the Answer
Question Category : Tuberculosis
Can you please tell me the latest recommendation of RNTCP in children? According to the WHO recommendation 2003, category I & III seem to be the same as per treatment.... which was not so in previous year recommendations. Please opine! Check Out the Answer
Question Category : Tuberculosis
After how many weeks of Anti Tubercular treatment can a child have a clear cytology in his CSF? Question 2) And is it contra-indicated to transfuse blood to a patient in hepatic encephalopathy with severe pallor (clinically) with no active bleeding? Check Out the Answer
Question Category : Tuberculosis
What is the role of steroids in tuberculous meningitis ? How many days it should be given? Check Out the Answer
Question Category : Tuberculosis
My son at age 1 year was diagnosed with TBM with hydrocephalus. CT scan on day 1 showed obstructive hydrocephalus and all the ventricles were dilated. Infarcts were seen in the left basal ganglia and hypothalamus. There was meningeal enhancement of the left sylvian fissure. Basal exudae were prominently seen. +'ve CSF report. Low grade fever, irritability end mild right facial palsy preceded for around 20 days. Unfortunately doctors could not identify and was basically treated for winter viral infection(distaclor, timinic,reglan etc.) Child had projectile vomiting the whole night intermittently and finally went into convulsion. Upon being rushed to hospital was treated with midazolam and convulsion contained.(got treatment within 45 minutes from convl onset).A second convulsion followed briefly within 3 hrs. Child was treated with usual ATT and prednisolone. We refused shunt. Two months later steroid was tapered and stopped. Ethambutol and pyrazinamide were also stopped. Rifampicin and INH continued. Phenytoin @ 5ml bd continued from day 1. There was tonic & clonic seizures. Stiff neck. Diplopia. Child had hemiplegia initially but improved with physiotherapy and time. 4 months down the line a follow MRI showed significant reduction in the ventricular. old infarcts were seen and sylvian enhancement present. During the entire period the child however had dramatic clinical improvement. Today its 6 months down the line. The following problems persist_ 1.Right side weaker than left 2.Do not prefer right hand 3.Problem of coordination of fingers of RH WHILE GRIPPING. 4.Very mild rt facial palsy. 5.Has learned to walk. 6.All other cognitive milestones are normal, rather excellent. Question: What shall be the follow up for the rest of his life @ a)Medical b)physiotherapy c)social d)parental guidance e)anticonvulsant therapy( no convl after day 1)f)Diet g)Precautions? Additional information:- Patient:- Krris/ born on 17.12.2005 @ optional c/section Date of convulsion:-16.12.2006 Probable source of contamination:-12 yr old unvaccinated neighbour suffering from pulmonary TB. We are from an educated middle class background living in a railway colony. Check Out the Answer
Question Category : Tuberculosis
One and half year male ATHARVA had Miliary koch's with Hepatosplenomegaly. He was born Preterm VLBW Gest age 32-34 wks (800 Grs.)& was getting recurrent resp. tract infections. His previous X rays were normal. For last Nine months he was on 4 drugs AKT (SHRZ)for 2 months & then 3 drugs AKT(HRZ)for last 4 months along with Oral Ofloxacin. He developed severe abdominal pain. H-S megaly is persistent. No urinary/ bowel complaints. Urine routine NAD. Deworming done, USG showing H-S megaly. No other positive findings. X ray chest shows still miliary shadows. Query (1) What could be the cause of his Abdominal Pain? (2) What modifications in the AKT will control is Miliary TB? Check Out the Answer
Question Category : Tuberculosis
A five year child presented in pediatric OPD with complaints of fever,cough and loss of appetite for 2 months. There is treatment history of Primary Complex for 6 months. In this child what is diagnostic significance of Mx test? Check Out the Answer
Question Category : Tuberculosis
Few Pediatricians in a nearby city are doing ADA testing almost routinely to diagnose tuberculosis {with little success, my observation!};My understanding is that the test is helpful in pleural, pericardial, CNS, abdominal tuberculosis; not useful when tested with serum as they are doing in their cases[have read two original articles of Indian Authors sometime back] ; the test is costly,>Rs 300/=.Is this advisable as a routine test for detection of childhood TB. Check Out the Answer
Question Category : Tuberculosis
1) Opened tuberculin vials can be kept only for two days. ref-(essential of tuberculosis in children, chapter 19 on tuberculin test, 3rd edition)please comment on this because CDC guideline states that it can be kept for 30 days. 2)is sputum induction better than gastric aspirates for detection of TB bacilli 3) what is the minimal cut off for mantoux test be taken for a child less than two years thanks nelson. Check Out the Answer
Question Category : Tuberculosis
What are latest regimens to treat congenital tuberculosis? Check Out the Answer

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