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Can TB treatment be started on suspicion of the disease?

Q: I am a 57 years old women suffering from fever frequently. The day starts with normal temperature and increases gradually to 100 degrees by the evening. Body feels weak and I also experience occasional night sweating. I have lost my appetite as well. My doctor (MD physician) got a few tests done and detected urinary tract infection (UTI). So, medication for UTI was given for 10 days. This brought down the pus cells from 45-50 to nil. However, the fever continued to bother me. So, the doctor felt the possibility of Tuberculosis (TB). Hence, Mantoux, RNA probe test for M. TB (improved PCR technique) and ANA were carried. All three results were negative. While tests were conducted, my doctor prescribed TB medication (Rifampicin etc.). Now, I feel better. The doctor says that though it tests for TB have come out to be negative, I have responded well to TB treatment and now I must undergo complete 6 months course. Is it right to undergo TB treatment without proper diagnosis?

A:Since treatment of tuberculosis is prolonged with the possibility of side effects, some of them serious, a firm diagnosis should be arrived at before starting anti-TB therapy. It is not correct to say that anti-TB drugs cause side effects if given to a patient who does not have the disease. The fact that patient is feeling better after taking anti-TB medicines is not a good enough proof that there is indeed tuberculosis. Please consult a tuberculosis/chest specialist.

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