Q: My 72 years old father is suffering from intermittent fever of 100-103 degrees. He is also a diabetic patient. During his lungs x-ray, doctors diagnosed bacterial pneumonia and started medication. He also underwent 15 days of medication through intravenous injection of drugs. He is admitted in the ICU. Earlier his blood sugar level was stable but now started fluctuating. He also feels tremors, chills and gets fever too. Initially his TLC count was 33500, which has now reduced to 13500. As per the doctors his chest has also got cleared, but he is still facing chills and tremors once or twice a day and after that he gets severe fever. Since fever is not subsiding now after treating pneumonia, doctors are suspecting tuberculosis and have started giving medicines for the same. He is feeling nausea and uneasiness after taking the ATT. Please suggest.

A:The high TLC count indicates that your father had severe infection / pneumonia. This can be associated with chills. If there is non resolving pneumonia the other possibilities to be considered are a fungal pneumonia, viral pneumonia with superadded bacterial infection, atypical bacteria causing pneumonias and tuberculosis. The doctors can do tests like bronchoscopy and BAL, CECT thorax to look for any enlarged/necrotic lymph nodes or abscess/cavity in the lungs, mantoux test, tb gold quantiferon, check for HINI by nose and throat swab, sputum for fungus and atypical organisms. In diabetics since the chances of tuberculosis are higher , that maybe the reason for starting ATT for a non resolving pneumonia.