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Do I have tuberculosis?

Q: My wife, 40 years old, had swelling on her feet. A small surgery was done and the pus sample was sent for Biopsy. The Report states: Necrotising granulomatous inflammation suggestive of Kochs. Which type of TB is this and is it infectious?

A:The information given suggests that pus sample was taken and sent to Histology which gave a provisional diagnosis suggesting Tuberculosis. I need further clinical information to establish certain key facts about your wife. I am not sure where was the pus sample taken from: ankle joint? soft tissue abscess? chronic ulcer, etc. Does she or anyone else in the family have chest symptoms like cough, breathlessness and constitutional symptoms like fever and weight loss? If this infection is confined to the foot and there are no household having any symptoms of chest/lung TB with productive sputum, then I would say this is not infectious on balance. But I need more information to get an appropriate risk assessment of the situation and I would be in a better position to advise accordingly. I am not sure if Pus sample was sent to Microbiology for routine culture and for culture of Mycobacteria (acid fast bacilli). Was ZN stain performed on this pus sample to look for acid fast bacilli? I hope that the above facts would be necessary to give further sensible clinical advice.


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