How to investigate for tuberculosis?
Q: I have fever upto 99.8 in the evening for the last 3 months. I have taken 4-5 antibiotic courses as prescribed by the doctor but have no relief. All the tests are okay. The urine report showed 2-4 pus cells per hpf and so was again on antibiotics. Doctor says it is a case of UTI. The TB test has been not done and my colleagues are advising I must go for that. Please advise how to proceed from here. Normal pattern of fever is 98.0, 98.9, 99.2, 99.2, 99.4-99.8 four hourly on daily basis. It remains the same even when I am in office or on bed rest.
A:I need to know your gender and age. You don't have UTI. There are two ways of getting tested for TB which you must get done. 1) overnight urine for AFB by fluorescent screen for three consecutive days or 2) urine for DNA PCR for tuberculosis. Besides this, get ultrasound for kidneys and see a general physician to treat you as case of PUO and if required, get a CT scan of abdomen. ESR, Mantoux test and TLC & DLC are important tests to be done and if required, to be repeated periodically. If TB is negative, and other tests are not leading to any diagnosis, bone marrow aspiration may be required.