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On World TB Day, doctors advise correct diagnosis before medication

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Jinal Shah

Posted: Mar 25, 2008 at 0251 hrs IST

Mumbai, March 24 On World Tuberculosis Day on Monday, as 12-year-old Akeeb Sheikh prepares to leave King Edward Memorial hospital in Parel, doctors who have treated him for lung infection have a word of caution — care needs to be taken to establish the diagnosis as tuberculosis in patients as the infection may be due to any other cause like presence of a foreign body leading to obstruction of the bronchus.

Akeeb, who had developed repeated infection over the last 12 years that resulted in removal of the lower lobe of his left lung, had inhaled a peanut while coughing when he was just four months old. “For a year, Akeeb repeatedly coughed and had breathing problems as his airway was obstructed. However, every time it subsided with the help of medication,” said Akeeb’s mother Shaina.

A resident of Dhulia, Akeeb was put on anti-tuberculosis drugs for six months as his X-ray had detected abnormalities. Doctors did not investigate the reason of the abnormality and concluded it as a case of tuberculosis. “When Akeeb turned one, the symptoms doubled and we consulted a doctor in Dhulia. A sputum test result showed negative and on the basis of the x-ray, we were told that he suffered from tuberculosis. We immediately started his treatment and completed a six-month anti-TB course. However, symptoms recurred,” added Shaina.

A year later, the peanut was detected and was removed. But by then, the damage was already done.

Over the next years Akeeb’s health deteriorated. He was taken to Wadia hospital for a check up. It was only in June last year that the severity of his condition was diagnosed and partial removal of his lung was recommended.

“Reviewing the clinical case it was seen that the patient had developed localized bronchiectasis which was the result of a foreign body’s presence. The foreign body was removed when the boy was one-and-a-half-years-old. The patient had, however, been treated with anti-TB medication for five months prior to the diagnosis of the foreign body,” said Dr Ameeta Athavale, head of chest medicine department, KEM.

“Akeeb’s left lower lobe of the lung collapsed with bronchiectasis. In spite of treating patient with chest physiotherapy and antibiotics, the patient was having recurrent symptoms in the form of repeated exacerbations with cough and expectoration requiring frequent courses of antibiotics affecting his quality of life. He was found to have a normal right lung. However, his left lung was partially damaged,” said Dr Athavale. Akeeb was operated on March 18 and is now set to go home.

“In smear negative pulmonary tuberculosis, every effort should be made to achieve a correct diagnosis via fibreoptic bronchoscopy that helps diagnosing 30 per cent extra cases and also helps in ruling out other conditions,” said Dr Athavale.

Sheikhs are relieved that Akeeb is not suffering from tuberculosis and that he will now lead a normal life.

jinal.shah@expressindia.com

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