Q: I was diagnosed with tuberculosis of the lymph nodes in the neck two years back. I went through ATT for nine months and stopped the medicines on doctor's advice. Recently, I noticed a serious lack of appetite, with recurring fever and pain in the neck. The Mantoux test showed positive again. I underwent FNAC on the neck, which confirmed a relapse/re-infection of tuberculosis. I wish to know whether or not the same medicines that I had taken earlier would work. Also, for how long should I continue ATT?

A:It is very important to do a complete microbiology work-up in your case to identify the mycobacterial species causing the infection (to confirm whether it is typical M. tuberculosis or atypical mycobacteria causing the infection). You shall have to get an AFB culture done. Also, get a drug susceptibility testing done, since there is a high risk of drug resistant TB or maybe atypical mycobacteria being the cause. The duration of treatment shall be 6-9 months depending on the drugs / regime used, but drug susceptibility data would be essential for optimal case management.