Download FREE Practo app
Get ₹200 HealthCash
Tuberculosis fever detected
My mom started having fever on 21st july and after 2 days fever was ok ,coughing remained . And done lots of doctor changes cough and antibiotic syrup changed but coughing didn't stopped.on 21st Aug with 4th doctor change we went for chest xray and ct scan for lungs .with xray doc suspected pneumonia but from.ct scan reports millary tuberculosis was identified. From 21st aug 4 tabs akurit 4 along with coughing antibiotic was prescribed.
Today is day 19.
In start 2 days she has high fever and cough
In mid 4 days fever recovered. Coughing remains. But from last 12 days there is a pattern that in midnight 2 am coughing starts heavily and continues and then till 4 am fever of 101 comes with shivering . Post taking paracetamol fever drops in 2 hrs. And in day time light coughing remains.
I want to know till when this fevr and cough remains.
Its 3rd week of medication and we are worried whether treatment is going in right .
Please guide on this. Thanks for helping out
Answers (33)
Need pulmonologist
Answered
Flag this answer
Let others know if this answer was helpful
Was this answer helpful?
YES
NO
Didn't find the answer you are looking for?
Talk to experienced doctor online and get your health questions answered in just 5 minutes.
+109
Please do tests including cbnaat, genexpert
With proper pulmonologist opinion then they will give her fixed dose combination of antitubercular drug regimen, which needs to be given as it is for 6 to 12 months depending whether it is drug sensitive or drug resistance tuberculosis
Answered
Flag this answer
Let others know if this answer was helpful
Was this answer helpful?
YES
NO
Consult pulmonologist
Answered
Flag this answer
Let others know if this answer was helpful
Was this answer helpful?
YES
NO
Her CT report suggests extensive TB involving both lungs; fever and cough can take several weeks to settle, so symptoms on day 19 alone do not prove treatment failure.
However, daily fever with shivering for 12 days after initial improvement needs review by her treating chest specialist today or within 24 hours.
The doctor should verify her Akurit-4 dose against her weight and review whether sputum CBNAAT/GeneXpert and culture with drug-sensitivity testing have been done.
Persistent fever can have several causes, including another infection, a medicine reaction or an inflammatory response to TB treatment; drug resistance also needs consideration.
Do not stop or change the TB medicines yourself, and do not rely only on paracetamol while waiting for the fever to disappear.
If she develops breathlessness, low oxygen, confusion, severe headache or repeated vomiting, take her to hospital immediately.
Dr. Pankaj Kumar
General & Lifestyle Physician
Answered
Flag this answer
Let others know if this answer was helpful
Was this answer helpful?
YES
NO
Pulmonologist
Answered
Flag this answer
Let others know if this answer was helpful
Was this answer helpful?
YES
NO
T.b. ,particularly miliary one is slow to resolve. Along with anti t.b drugs, give her syp tusq dx 5m.l. every 8hours for 5 to 7 days.
Answered
Flag this answer
Let others know if this answer was helpful
Was this answer helpful?
YES
NO
LISTEN TYPE OF TUBERCULOSIS
MILLIARY TUBERCULOSIS MOST DIFFICULT TYPE OF TUBERCULOSIS. PATERN OF FEVER
EVENING RISE
+COUGH +
LACK OF APPETITE
R TYPICAL FEATURES OF TUBERCULOSIS. TREATMENT IS ALSO PROLONGED APPRX 9 MONTHS.
CONTINUE TREATMENT KEENLY WITH LFT OFF N ON .
Answered
Flag this answer
Let others know if this answer was helpful
Was this answer helpful?
YES
NO
Fever and cough can take several weeks sometimes longer to fully settle in miliary TB, even with correct treatment; day 19 is still within a common window for ongoing symptoms
Answered
Flag this answer
Let others know if this answer was helpful
Was this answer helpful?
YES
NO
Might take a month or half
Answered
Flag this answer
Let others know if this answer was helpful
Was this answer helpful?
YES
NO
Miliary tuberculosis is a severe, potentially Fatal form of Tuberculosis caused by the Widespread
Bloodstream dissemination of Mycobacterium
Tuberculosis.
Note= To know the weight of Patient is very essential to calculate the Dose of Antitubercular Medication in case of TB.
I am not sure whether correct DOSE of 4 drug
Regiment is correctly calculated on the Basis of ( weight/ kg)
Antitubercular drugs should not be ever missed a single Dose during the entire duration of treatment.
With Adequate Dose and Diet Patient recovery starts around in month, Patient start feeling better and Fever subsides and appetite improves.
DIET = High-Calorie and High-Protein diet is a essential for Tuberculosis patients for repair of body tissue and Strengthen the immune system.
Vitamins And Minerals = all kinds of fruits
Egg,nuts
If you want to calculate the exact Dose of TB
Medication share the Weight.
Feel free to contact for any clarification.
Next Steps
INVESTIGATION
Reguar LFT and KFT need to be done...
Answered
Flag this answer
Let others know if this answer was helpful
Was this answer helpful?
YES
NO
CBNAAAT SHOULD BE ADVISED THOUGH TB IS SUSPECTED, FURTHER ANTITUBERCULAR TREATMENT SHOULD BE ADVISED ACCORDING TO THE STANDARD TREATMENT PROTOCOL.TILL DATE AVOID DIRECT CLOSE VICINITY CONTACT.
Health Tips
betadine gargles routinely
Answered
Flag this answer
Let others know if this answer was helpful
Was this answer helpful?
YES
NO
A good case here to indulge in. Need to know more and have questions.
Next Steps
CONSULT NOW
Answered
Flag this answer
Let others know if this answer was helpful
Was this answer helpful?
YES
NO
This is an open case of TB with cavitation. She can spread infection to others. She has to be admitted and treated at a TB centre by a specialist pulmonologist
Next Steps
Miliary Tb spreads through blood to multiple organs ,so get her admitted as Early as possible
Answered
Flag this answer
Let others know if this answer was helpful
Was this answer helpful?
YES
NO
The CT picture is highly concerning for miliary/active TB, treatment has only been given for 19 days, and cough may take weeks to improve. However, the recurrent fever + chills after initial improvement needs evaluation now to ensure there isn’t another infection, drug resistance, treatment/adherence issue, or complication.
Next Steps
Confirm microbiologically with sputum Xpert MTB/RIF Ultra ± culture/DST if not already done; assess adherence, drug tolerance/absorption, and look for bacterial/other infection or drug resistance. Check vitals/SpO₂ and appropriate CBC, LFT, renal function
Health Tips
Do not stop or change Akurit-4 without the treating TB physician.
* Urgent hospital review if breathlessness, low SpO₂, hypotension, confusion, severe weakness, significant hemoptysis, persistent high fever, or inability to take medicines develops
Answered
Flag this answer
Let others know if this answer was helpful
Was this answer helpful?
YES
NO
Persistent fever and cough despite 2â3 weeks of treatment needs prompt reassessment, not repeated antibiotic changes.
Please review the exact TB test/report, chest X-ray/CT, sputum results and current medicines with a physician; confirm adherence and rule out drug resistance or another infection.
Seek urgent care if there is breathlessness, chest pain, confusion, low oxygen or worsening fever.
You can share the reports through a Practo consult for a detailed review, or visit me at Synergy Multispeciality Hospital, Miraj.
Answered
Flag this answer
Let others know if this answer was helpful
Was this answer helpful?
YES
NO
reassessment needed by the treating physician to confirm adherence, drug response and complications or another infection don’t stop or change yourself.
Answered
Flag this answer
Let others know if this answer was helpful
Was this answer helpful?
YES
NO
If you would like to discuss your concern in more detail, please feel free to contact me on WhatsApp at nine one one nine two five five six nine nine. Alternatively, you can connect with me through the Practo app for a detailed consultation
Answered
Flag this answer
Let others know if this answer was helpful
Was this answer helpful?
YES
NO
If you would like to discuss your concern in more detail, please feel free to contact me on WhatsApp at eight six one nine six six nine nine zero six. Alternatively, you can connect with me through the Practo app for a detailed consultation
Answered
Flag this answer
Let others know if this answer was helpful
Was this answer helpful?
YES
NO
kindly do connect and consult with me for better treatment plan and advice on your case via PRACTO app
Answered
Flag this answer
Let others know if this answer was helpful
Was this answer helpful?
YES
NO
Dr. Praful Mahamuni
General Practitioner
20 yrs exp
Nagpur
Hello,
Take Balanced diet.
For diet details and ePrescription consult by practo app or contact me at WhatsApp at +91959508739nine.
In future if consultations are required than consult by practo app or contact me at WhatsApp at +91959508739nine.
Thanks.
Answered
Flag this answer
Let others know if this answer was helpful
Was this answer helpful?
YES
NO
Dr. Gaurav Jaiswal
General Physician
7 yrs exp
Jhansi
Avoid fried and spicy food
Water intake more
Green leafy vegetables more
Fiber meal
Walk
Do connect and consult
Will help you
Answered
Flag this answer
Let others know if this answer was helpful
Was this answer helpful?
YES
NO
Dr.Mohit singh
General Physician
3 yrs exp
Jhunjhunu
Based on the history in the screenshot, this needs reassessment by the treating TB/chest physician rather than simply waiting for the fever to disappear.
What may be happening
* She was diagnosed with miliary TB on CT and started Akurit-4 about 19 days ago.
* Some cough can persist for several weeks even after effective TB treatment has started.
* However, recurrent fever around 101°F with shivering every night after nearly 3 weeks of treatment deserves review. It does not automatically mean the TB treatment is failing, but other possibilities need to be considered.
These include:
1. Ongoing inflammatory response to TB despite appropriate treatment.
2. Paradoxical reaction — symptoms can temporarily worsen after starting effective TB therapy.
3. Another infection/coexisting pneumonia, particularly if the fever pattern is new or worsening.
4. Drug-resistant TB or inadequate drug exposure, especially if drug-susceptibility testing has not been performed.
5. TB involving another site, particularly CNS or pericardium, which is important in miliary disease.
6. Drug-related fever or another medication-related problem.
WHO guidance emphasizes appropriate drug-susceptibility-based TB treatment and monitoring during therapy.
About the 4 tablets of Akurit-4
Akurit-4 contains the four first-line TB drugs, but whether 4 tablets is the correct dose depends on her body weight and the exact formulation prescribed. Don’t increase, decrease, or stop it without the TB physician’s advice.
What I would recommend now
Because she is having 101°F fever with chills/nightly recurrence, contact her treating physician now/within 24 hours and discuss:
* CBC, LFT and renal function
* Oxygen saturation and clinical examination
* Review of the CT chest
* Confirmation that CBNAAT/Xpert and rifampicin-resistance testing (and further DST where indicated) were done
* Review of adherence and exact Akurit-4 dose according to weight
* Assessment for another infection if clinically indicated
* Consideration of other sites of disseminated TB depending on symptoms/examination
Do not stop the TB medicines just because fever is continuing.
When to go to hospital urgently
Go urgently if she develops breathing difficulty, SpO₂
Answered
Flag this answer
Let others know if this answer was helpful
Was this answer helpful?
YES
NO
Dr. Praveen Kumar
General Physician
4 yrs exp
Jaipur
Based on the history + HRCT report in the photos, the overall picture is concerning for active tuberculosis with a miliary/nodular pattern, but the CT alone does not prove TB microbiologically.
CT report ka simple conclusion
The HRCT describes:
* Multiple tiny/miliary nodules in both lungs
* Tree-in-bud appearance, particularly in upper lobes → suggests active endobronchial spread of infection, commonly TB.
* Mediastinal/hilar lymph nodes, largest around 15 × 20 mm
* No pleural or pericardial effusion.
The radiologist has specifically written “s/o miliary Koch’s” → meaning miliary tuberculosis is suspected.
19th day of anti-TB treatment par fever?
Day 19 par 101°F fever with shivering + persistent cough should not simply be assumed to be normal TB fever.
Possible explanations include:
1. TB-related inflammation still settling — cough can take several weeks to improve.
2. Paradoxical reaction — sometimes symptoms temporarily worsen after starting effective ATT.
3. Another infection/co-existing pneumonia.
4. Drug-related fever or another adverse reaction.
5. Treatment issue/resistance, especially if TB was not microbiologically confirmed or adherence/dosing is problematic.
Important: Paracetamol se fever temporary down hona cause ko rule out nahi karta.
Next Steps
What I would recommend
Because this is suspected miliary TB + recurrent high fever with chills, she should be reviewed promptly by a pulmonologist/physician, rather than waiting for the cough/fever to disappear on its own.
The doctor should verify:
* Was sputum/induced sputum Xpert MTB/RIF/Ultra or another microbiological test done?
* TB drug-susceptibility results, if available.
* CBC, LFT, renal function and other relevant tests.
* Oxygen saturation and clinical examination.
* Whether the fever is actually TB-related or another infection.
* In confirmed/suspected miliary TB, assessment for extrapulmonary involvement, particularly neurological symptoms.
Do not stop or change the anti-TB drugs yours
Health Tips
If she develops breathing difficulty, low oxygen saturation, confusion/severe headache, persistent vomiting, jaundice, severe weakness, coughing blood, or rapidly worsening fever, she should be taken to an emergency department.
Answered
Flag this answer
Let others know if this answer was helpful
Was this answer helpful?
YES
NO
Dr. Swati Hegde
Consultant Physician
16 yrs exp
Bangalore
She requires pulmonologist opinion.. register with NTEP . Correct Dosage as per her weight. CBNAAT / gene Xpert has to be done
Answered
Flag this answer
Let others know if this answer was helpful
Was this answer helpful?
YES
NO
Dr. More Atul Hanumant
General Physician
2 yrs exp
Aurangabad
Stop Doctor-Shopping. Stick with one primary care physician or consult a Chest Specialist. A single doctor needs to track your progress over time rather than restarting treatment from scratch.
Next Steps
Be compliant with the treatment provided by specialist
Answered
Flag this answer
Let others know if this answer was helpful
Was this answer helpful?
YES
NO
Dr. Anuj Mothsra
General Practitioner
7 yrs exp
Jhunjhunu
Can help you, kindly consult and provide detailed history for proper diagnosis and further management
Answered
Flag this answer
Let others know if this answer was helpful
Was this answer helpful?
YES
NO
Dr. Ankita Gahlot
Obstetrician
12 yrs exp
Bangalore
Fluctuating fever and night cough are common in the first few weeks of TB treatment, so this pattern alone doesn't mean the treatment isn't working.
Next Steps
Please share this exact pattern with your treating doctor at your next TB follow-up so your response can be checked properly.
Health Tips
If fever crosses 102 F often, breathing becomes difficult, or you lose weight, please get reviewed sooner instead of waiting for the scheduled visit.
Answered
Flag this answer
Let others know if this answer was helpful
Was this answer helpful?
YES
NO
Ms. Prateeksha Singh
General Physician
2 yrs exp
Etah
Kindly take proper treatment of tuberculosis registered in government hospital and take treatment
Answered
Flag this answer
Let others know if this answer was helpful
Was this answer helpful?
YES
NO
Dr. Reesha Varshney
General Physician
1 yrs exp
Hathras
This might take time
Did you go for cbnaat and dots registration for tuberculosis??
Answered
Flag this answer
Let others know if this answer was helpful
Was this answer helpful?
YES
NO
Dr. Vetsa Sri Krishna Chaitanya
General Physician
7 yrs exp
Rajahmundry
Need a few more details please consult for further evaluation and treatment
Answered
Flag this answer
Let others know if this answer was helpful
Was this answer helpful?
YES
NO
Dr. Suraj Sharma
General Practitioner
4 yrs exp
Jaipur
Do consult
Answered
Flag this answer
Let others know if this answer was helpful
Was this answer helpful?
YES
NO
Dr. Karamthot
General Physician
3 yrs exp
Nandyal
Even if the CT show changes related to Tuberculosis,, consult your doctor and give early morning sample for culture
Answered
Flag this answer
Let others know if this answer was helpful
Was this answer helpful?
YES
NO
Dr. Ashita Kuruvilla
General Practitioner
8 yrs exp
Kolkata
Need few more details for further evaluation. Please consult
Answered
Flag this answer
Let others know if this answer was helpful
Was this answer helpful?
YES
NO
Articles you may like
Disclaimer : The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding your medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.
The question asked on this page is a free question. You can ask a free health question by downloading the Practo app.
Articles you may like
Tell us what's troubling you
Tell us what's troubling you
Disclaimer : The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding your medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.