Q: My husband is 61 years old. He is suffering from a breathing problem. He was diagnosed with idiopathic lung fibrosis 2 years back. Our doctor told us to rule out tuberculosis so we did the blood test. In the ELISA test it came positive. It was also detected in blood PCR test. He was taking Azaron 50mg twice a day with prednisolone. Since the last month, he is taking Defcort 30 mg and goutnil 0.5 mg. His symptoms are dry cough sometimes with soapy sputum, breathless after walking, climbing. Today he was very breathless. I am very worried. His weight has decreased. Please let me know what is he suffering from? If he has TB, will he be alright?

A:Pulmonary fibrosis is usually very difficult to treat. It often is unresponsive to steroids or to the immunosuppressive agents that are used in standard therapeutic regimens. Often the disease is complicated by concomitant bronchitis or bronchiectasis and even asthma. Furthermore, tuberculosis of the usual type and atypical forms can occur as can fungal infections. Each complication has to be either treated if it occurs; sometimes it is appropriate to use prophylactic therapy expectantly, in particular to prevent reactivation of old TB. Although there may be no definitive therapy, oxygen can provide relief and antibiotics can be used selectively for exacerbations. No alternative therapies are of proven value although it is probable that any good antioxidant such as acetylcysteine would help prevent disease progression. However serious lung disease requires the direct help of a pulmonary specialist.