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What are the chances of recurrence of tuberculosis?

Monday, 22 November 2010
Answered by: Dr Sanjay Bhattacharya
Associate Consultant, Department of Microbiology, Tata Medical Center, Kolkata
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Q. I am a 30 years old female who had a biopsy in my right side of the neck two years back because of the swelling in the lymph nodes. The doctor confirmed it as tuberculosis and I have taken treatment for nine months – AKT 4 for two months and AKT 3 for seven months. Now I am fine. What are the chances of recurrence of tuberculosis?

A.  With adequate and appropriate treatment tuberculosis (TB) is a curable disease. This generally means taking the right combination of medicines, at the right doses, at the right time, for the right duration. Because TB caused by the bacteria Mycobacterium tuberculosis is an intra-cellular infection (this means that the bacteria generally reside inside the cell as opposed to extra-cellular infection which is the case for most other bacteria) there is a possibility of some bacteria escaping the action of drugs, and remaining dormant for long periods of time, and then reactivating several months or years later, when the bodies defence (immunity) mechanisms are down due to other diseases or immunosuppressive medications. The rate of reactivation of latent TB is variable, but may range from 5 to 15% (as per the results of some studies). It is good that you have finished treatment and feeling fine. Cure in TB is generally defined by resolution of symptoms and signs (in your case subsidence of swelling of the lymph nodes), resolution of other symptoms (if present initially such as fever, weight loss, lack of appetite), fall in inflammatory markers (e.g. CRP or ESR), radiological improvement (if applicable to the particular case). There is no single test present currently which could be defined as a test of cure for TB.

A.  With adequate and appropriate treatment tuberculosis (TB) is a curable disease. This generally means taking the right combination of medicines, at the right doses, at the right time, for the right duration. Because TB caused by the bacteria Mycobacterium tuberculosis is an intra-cellular infection (this means that the bacteria generally reside inside the cell as opposed to extra-cellular infection which is the case for most other bacteria) there is a possibility of some bacteria escaping the action of drugs, and remaining dormant for long periods of time, and then reactivating several months or years later, when the bodies defence (immunity) mechanisms are down due to other diseases or immunosuppressive medications. The rate of reactivation of latent TB is variable, but may range from 5 to 15% (as per the results of some studies). It is good that you have finished treatment and feeling fine. Cure in TB is generally defined by resolution of symptoms and signs (in your case subsidence of swelling of the lymph nodes), resolution of other symptoms (if present initially such as fever, weight loss, lack of appetite), fall in inflammatory markers (e.g. CRP or ESR), radiological improvement (if applicable to the particular case). There is no single test present currently which could be defined as a test of cure for TB.

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