Am I under the right treatment for miliary tuberculosis?
Q: I am a 24 years old male. I have been diagnosed with miliary tuberculosis and the doctors have prescribed treatment with Cat-I dots. Due to some reasons, I haven't got the dots treatment, instead I am now taking forecox tablets which has rifampicin, INH, pyrazinamide and ethambutol along with omnocortil tablets. Is it okay to take forecox instead of DOTS? What are the side effects of omnocortil tablets? I have a mild headache also. Is there any special drug except the above four to treat MTB quickly and effectively?
A:Miliary tuberculosis (TB) is the widespread infection in the body due to Mycobacterium tuberculosis. Classic miliary TB is defined as millet-like (average 2 mm size) seeding of TB bacilli in the lung, as seen on chest x-ray. This pattern is seen in nearly 1-3 percent of all TB cases. The infection is characterised by a large amount of TB bacilli, although it may easily be missed. Up to 25 percent of patients with miliary TB may have meningeal involvement. Adequate attention to nutrition is important, since many patients with miliary TB are debilitated by the disease, and malnutrition can contribute to a weakened immune system. Directly observed treatment short course means that the medicines are taken by the patient seen by a health worker. Though directly observed therapy is optimal for assuring compliance and preventing relapse, you can take the drugs prescribed for you at home - directly observed by someone from your family, just to ensure compliance. Omnacortil is a steroid, which may be required for hyprotension due to presumed adrenal insufficiency after an adrenocorticotropic hormone (ACTH) stimulation test, or due to meningeal involvement.One of the side effects of steroids is high BP manifesting as headaches. Getting your blood pressure checked is advisable. All your close contacts, who might have been infected before starting treatment, should be screened for TB. Your activities should be restricted till you receive several weeks of effective treatment, have significant clinical improvement, along with negative sputum acid-fast bacilli (AFB) smears. If you live in a home with immuno-compromised persons (e.g., with HIV infection) or with children younger than 5 years it is better to stay in hospital until sputum smear (AFB) results are negative and significant clinical improvement is seen.