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DR. EHTISHAM
DR. EHTISHAM, Doctor
Category: Medical
Satisfied Customers: 2214
Experience:  MBBS, FCPS
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My dad a 65 yr old man was a very healthy man didn't consume

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My dad a 65 yr old man was a very healthy man didn't consume any alcohol and he's not a smoker he is diabetic and has high blood pressure and he was on his regular meds and he was working until February 2016 suddenly he had a mild seziure and we rushed to the hospital and he did an MRI that showed that he has multiple brain lesions and it was diagnosed using spectroscopy as Brain TB and also we did the skin test and the blood test they both showed positive and he started the 4 anti-tb drugs since March 2016 the latest MRI done 2 days ago showed that the lesions size had grew bigger it was 8.8 now it's 12 the duration between the two MRI's is a 4 month period of time so is that possible it's TB and the lesions are getting bigger although he's taking the TB meds??
Can his body be resistant to the meds and he needs the 2nd line of TB drugs?
Is it normal or to it should get smaller after 12 to 18 months period?
He's suffering also from papellidema and intracranial pressure.
Yet we can see that he is generally doing better his concentration,focusing and talking well and remembering please advise Doctor.
Medications as follows
Meds after sickness
1.Rifadin 300 mg
2.Pdp-isonazid
3.Azarga eye drops
4.Depakine chrono 500 mg
5.Insulin 50/50 (38 units before breakfast)
Meds before sickness
1.Coveram 5/10
2.Jusprin
3.Galvusmet 50/850
4.Vitamin B complex
5.Amaryl 6 mg which was replaced b insulin
6.Omega 3 plus
Submitted: 1 year ago.
Category: Medical
Expert:  DR. EHTISHAM replied 1 year ago.

Hi

Welcome to JA and thanks for asking

It is not usual to have a good response and yet the size of the mass in the brain continue to increase in size.

Two possibilities need to be considered here

First is the possibility of a drug resistant TB in which case he will need to repeat a culture sensitivity test. Culture should be done on the blood and CSF as well.

Second thing which should be ruled out is the possibility of some malignant process so if the culture testing doesn,t yield anything and he continue to have a worsening MRI a definite diagnosis will require a brain biopsy to be absolute sure about the cause of this mass lesion

Good luck

Feel free to ask if you have any more question

Please leave a POSITIVE (3 – 5 stars, preferably 5) rating by clicking on the stars above, until you do i am not compensated for my time. You can continue to ask follow-up questions even after the POSITIVE rating

Regards

DR. EHTISHAM and 2 other Medical Specialists are ready to help you
Customer: replied 1 year ago.
He did a full body scan it came back clean
CT scan aslo clean
No other lesions appearing anywhere in the body
Expert:  DR. EHTISHAM replied 1 year ago.

Thanks for sending the report

As i mentioned as the mass lesions are increasing despite being on anti tuberculous therapy so a reevaluation for drug resistance TB or another possibility like a fungal infection or malignancy needs to be ruled out. So he need further investigations as i mentioned above

Good luck

Please leave a POSITIVE (3 – 5 stars, preferably 5) rating by clicking on the stars above, until you do i am not compensated for my time. You can continue to ask follow-up questions even after the POSITIVE rating

Regards