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Tuberculosis

Could it be TB

02/02/2006

Question:

Hello, I have been suffering from chronic left quadrant pain (at my waist) that travels around to the left side of my lower back or vice versa. Initially, my PCP thought I may have kidney stones which was believed to be seen on a PET scan. We finally realized that was not it. I have had a battery of tests such as 2 MRIs on my back, endoscopy, colonoscopy, pelvic ultrasounds, IVP x-ray, various other x-rays, barium enema,upper GI, hospitalized 3 times for management of pain. I also had consultations with both urologists and gastroenterologists. My gynecologist did a cystoscopy and laproscopy but found only a small inguinal hernia. This was repaired surgically over a month ago and all my Dr.s told me there was a possibility that this would not fix my pain. Which I believed it has not. Because of the longevity of this illness as well as suffering from Restless Leg Syndrome, I have had to take depression medication. I am just wondering if tubercolosis could be the cause of this side pain. My father is a carrier of the disease. Two days after my hernia surgery, I was hospitalized for chest and back pain and my CT scan showed white furry spots on my lungs that I was told could be the start of pneumonia. Lately, I have been short of breath. But this has just began in the last month since my operation. I also have noticed lumps of cartilage?, I guess you would call them, in my nose. Anyway, my doctors I believe don`t know which way to turn now and can only try to relieve my pain if it gets too severe. What exams/tests are needed to diagnose TB. Thank You!

Answer:

You should have a TB skin test placed and a urine sample sent for my cobacteria culture (also called AFB culture) to look for renal tuberculosis.  However, it doesn't seem likely that's what's causing your pain.  Flank pain is usually a late sign, usually associated with characteristic abnormalities on an IVP x-ray.  If your father was latently infected with TB ("a carrier"), then he was not contagious to others.

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Response by:

Lisa A Haglund, MD Lisa A Haglund, MD
Associate Professor of Clinical Medicine
College of Medicine
University of Cincinnati