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On tb medication but fever still there
I am having abdominal tb which got confirmed by omental biopsy and genexpert said traces found. I am taking medicines since 40 days but fever is not decreasing it's still 103 with chills. I did chest xray yesterday and it was normal. Esr and crp levels raised from 30 to 50 and 77 to 89 respectively. Lft rft cbc normal
Answers (18)
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Abdominal TB takes longer time to recover than the normal counterpart. Follow the appropriate regimen as recommended by your consultant. Sometimes, other infections or anaemia may be associated with this condition, also check your appendix status due to prolonged fever. Change the antibiotic course (Additional) if taken apart from regimen and treat any swelling in your body (Neck, Chest, Abdomen).
Next Steps
Do CBNAAT after 2 months of Intensive phase (If 6 months regimen followed).
Repeat CBC and X-Ray, also do Serology for other illness.
Health Tips
Avoid contact with household/ workspace.
Adequate rest and proper follow up with medications.
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Tuberculosis is a chronic disease and its fever is always low grade fever and never with chills , in Tuberculosis patient generally complaint that they have evening time generalised weakness and they have a feeling that fever is there but it is not showing on thermometer reading (sometime such low grade ) , so it may be possible that you are having some other infection /superadded infection too .
Next Steps
kindly get tested for malaria .
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Persistent high fever after 40 days of treatment for abdominal TB may indicate treatment failure, or drug resistance, or secondary infection, because of increased ESR and CRP.
Better to :Recheck drug sensitivity (DST)
Follow correct timing and correct dosing
There might be other infections (urine, blood, abdominal abscess)
further evaluation is needed.
Follow-up with your physician or TB specialist
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What other symptoms do you have besides fever?
How is your appetite?
Do you have any swelling anywhere on your body?
Do you feel overall better or worse compared to before starting treatment?
Persistent fever despite taking ATT can have several causes : including drug-resistant TB, a paradoxical immune reaction i.e., now that your immune system is getting better it's trying to control the infection thereby causing fever, drug-induced fever from ATT, or TB-related complications like abscess formation.
It’s best to consult your primary physician for further evaluation and appropriate workup.
Next Steps
Consult primary physician.
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