It’s been couple of
months since we started to serve at
Kachhwa.
One of the things that
that has followed us here from NJH is the
high prevalence of Tuberculosis. I only wonder if the prevalence is a bit more higher than Palamu region as the density of health care institutions including tertiary centres are more here.
I personally saw 4
pulmonary tuberculosis patients, 2 abdominal tuberculosis, 1 tuberculous
lymphadenitis and 2 tuberculous meningitis. The experience in NJH has been such
that we have the diagnosis of tuberculosis in the back of our mind once the
patient complains of cough or comes with vague complaints. I’m sure many would
echo my view.
Couple of interesting
cases . . .
DES, a 45 year old lady
came to us about couple of weeks back with pain on passing urine and vague
abdominal pain. We sent her for routine urine examination which showed a bad
urinary tract infection. She was started on oral antibiotics, but did not
respond to treatment. She came back. Ultrasound showed features of early
pyelonephritis. She was admitted and started on intravenous antibiotics.
She did not improve.
Rather, after admission, she started to complain of breathlessness at night.
Later, on probing, she told us she has been breathless since the abdominal pain
started. We took a Chest X-Ray.
Miliary tuberculosis was
the diagnosis. She was started on treatment. And the recovery was dramatic. DES
is at home now.
The second story is that
of a little boy and his grandmother. MS, a 2 year old boy was brought with
history of long standing cough. MS weighed just about 5 kilograms and on
probing gave a history of exposure to probable tuberculosis. His grandmother
was a chronic cough patient and had taken 2 months of tuberculosis treatment.
Meanwhile, in another
cubicle of our hospital, another doctor was examining his grandmother and had
made the diagnosis of tuberculosis. The parents did not think it wise to tell
to the doctor who examined MS, that his grandmother had also come and was being
examined at another cubicle.
Below is MS’s X-ray. We
were quite taken aback at the extent of the disease.
Meanwhile, MS’s
grandmother also got her X-Ray. Later, her sputum was also positive.
It took some time before we
realised that both MS and his grandmother was diagnosed to have tuberculosis
the same time in our hospital without the knowledge of either doctors.
When, we told the family
that MS should have got the disease from his grandmother, the family was not
willing to believe stating that MS visits his grandmother only once a month.
This is nothing uncommon
that we see when we try to educate people about the spread of the disease.
There is one more patient
whose story I wanted to narrate. That would be in another post . . .
