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AR15.COM
12/28/2004 6:53:32 PM EDT
You guys have sure been overworked lately. Up to some more questions?

My FIL has had "pneumonia" for over two months according to the quack he goes to. And yes, I think you guys will agree he is a quack when you here this.

2 months ago started coughing up stuff, some trouble breathing. Dr gave him antibiotics and told him he would be ok.

~ 1 month ago he was having more trouble breathing and coughing up more sputem, went back to Dr and was given a different antibiotic.

~ 2 weeks ago he was having so much trouble breathing he had to have oxygen occasionally. Dr told him he was just taking longer to get over it and not to worry. At this point my wife drove over there (we're three hours away) and hauled him to another Dr who freaked out and told Dr 1 to get him in the hospital and get this cleared up with IV antibiotic 2x/day. Oh, FIL is 84, has adult onset (I think that's the term) diabetes.

He has been showing improvement with the antibiotics and some therapy which includes some machine that pounds his back to help break loose the congestion in his lung. They identified the bacteria in his lungs and the antibiotic has definitely been working as the level is going down. Now we just got a call tonight that the Dr released him this evening. Told FIL to wear a mask as they had also found tuberculosis.

So, what does this mean? How contagious is this? Does everyone who had contact with him have to get tested? Etc., etc., etc?

Thanks,
NMSight
12/28/2004 6:55:04 PM EDT
[#1]
Not a doctor but I would suggest a test for TB if you have been in close contact. Can never be too careful. It's a simple poke the skin with a set of needles test, doesn't hurt a bit. At least that's how the one I had was done.
12/28/2004 6:58:09 PM EDT
[#2]
I would get everyone in the family a PPD test.  TB is immune to most antibiotics and takes a significant amount of time to clear.  The test will take 2-10 weeks after exposure and intitial infection to become positive.  Most people have latent TB and this occurs when the bacterium is walled off and no longer poses a threat. It can become active later in life.  Majority of people do ok and do not get seriously ill.  People who have diabetes or are on steroids, HIV or other immun deficiency diseases are at a much higher risk.
12/28/2004 6:58:59 PM EDT
[#3]
tb is very contagious, the arm prick test will show you to have it, or have been around it to have made antibodies for it
12/28/2004 6:59:27 PM EDT
[#4]
My chick tested positive for the TB virus or something.  Like having the HIV of TB.  She had to take some pills.  I think she is better now.  If not, I will buy a revolver and start practicing my "i'm your huckleberry" line
12/28/2004 6:59:28 PM EDT
[#5]
TB is an airborne pathogen, anyone living/working in close confines with him should be checked for infection.
There are several treatments available depending on the resistance of it, most treatments are comprised of a pill (or two) taken daily.
A skin test will show if you have been exposed, an X Ray will show growth, and a sputum test over 3 days can confirm infection.
12/28/2004 7:01:15 PM EDT
[#6]
TB can re-activate in people who have a weakened immune system.  

No flame, but you haven't given us enough information to really comment.  Did they find calcified lesions on X-ray in the upper lung lobes suggesting old dormant disease, or did they find +AFB (acid-fast bacilli) stains in the sputum to suggest an active pulmonary tuberculosis infection?  Like Zack3g said, it wouldn't hurt to have peole tested for exposure with the skin test.
12/28/2004 7:03:28 PM EDT
[#7]
I would second the PPD(Purified Protein Derivitive). It's painless, and will answer any questions about exposure.  Go get it done. TB sucks the big one and is pretty contagious.
12/28/2004 7:04:18 PM EDT
[#8]

Quoted:
TB can re-activate in people who have a weakened immune system.  

No flame, but you haven't given us enough information to really comment.  Did they find calcified lesions on X-ray in the upper lung lobes suggesting old dormant disease, or did they find +AFB (acid-fast bacilli) stains in the sputum to suggest an active pulmonary tuberculosis infection?  Like Zack3g said, it wouldn't hurt to have peole tested for exposure with the skin test.



No, I didn't give you much info because I don't have much. I'll see if I can get some more answers.

BTW, thank you guys for all the input so far.
12/28/2004 7:09:59 PM EDT
[#9]
BTW you dont have to have TB only in the lungs (estrapulmonary TB).  TB can infect anywhere in the body and we have seen TB infection in the genital tract.

I worked with TB that was resistant to most antibiotics that are currently in use in medical school.  The scary part about this is that we were getting our specimens from homeless folks that were coming through the ER.  Its scary because if you happened to be unlucky enough to get the MTB you were screwed and only luck would save your ass.  We used massive amounts of antibiotics to get results and the levels became toxic to the patient.  It was very interesting to say the least.
12/28/2004 7:23:05 PM EDT
[#10]
Doc #1 seems mighty casual about pneumonia in an 84 year old.
12/28/2004 7:27:28 PM EDT
[#11]

Quoted:
BTW you dont have to have TB only in the lungs (estrapulmonary TB).  TB can infect anywhere in the body and we have seen TB infection in the genital tract.

I worked with TB that was resistant to most antibiotics that are currently in use in medical school.  The scary part about this is that we were getting our specimens from homeless folks that were coming through the ER.  Its scary because if you happened to be unlucky enough to get the MTB you were screwed and only luck would save your ass.  We used massive amounts of antibiotics to get results and the levels became toxic to the patient.  It was very interesting to say the least.



I brought up this point when we were talking about giving healthcare to people who can't afford it and it was glossed over.  I have seen enough cases of multi-drug resistant TB to realize that these people need to be treated regardless if they have health care.  One of the more interesting sites I have seen systemic TB is in the bone marrow.  Had a woman in the hospital for months and the Docs. could not find her source of infection until a repeat test discovered the TB in her bone marrow.
12/28/2004 7:29:32 PM EDT
[#12]

Quoted:
tb is very contagious, the arm prick test will show you to have it, or have been around it to have made antibodies for it



wrong.  not very contagious, takes prolonged exposure of an active carrier.  The ppd refered to above will only show previous exposure.  

all family members should be tested now and in a few months for conversion, anyone testing positive should be tested for afb, have a chest film, and possibly be treated.