My mother has been diagnosed with Spinal Tuberclosis


Q: My mother has been diagnosed with Spin Tb and it is effecting her D11-D12 & L1 vertibra. On Doctor's advice we started following medicines
1. RCINEX 600 mg BBF
2. PZIDE 2000 mg OD
3. MYCOBUTOL 1000mg OD
4. BENEDON 20mg OD

The above medicines were taken for 1 month starting from 28th Jan 2015.

After that, mother got tested for LFT report on 25th Feb 2015 and found that three values – SGOT, SGPT and GAMMA GT were deranged.

Doctor immediately discontinued RCINEX and PZIDE medicines and advised the following as per prescription dated 25 Feb 2015.
1. Levoflox 750mg OD
2. MYCOBUTOL 1000mg OD
3. LIV 52 Twice daily

So we got her tested for LFT again after 10 days and found that these values SGOT, SGPT are back in range so RCINEX 450 mg (BBF) was again started by the doctor .

Since 16th March 2015, Patient is taking all the four medicines (RCINEX 450 mg, Levoflox 750mg, MYCOBUTOL 1000mg, LIV 52 )

Symptoms:  My mother is unable to move and has severe back pain. Pain has also extended to legs.
It is very difficult for the patient to remain without taking painkillers.
She also has fever from the last 15 days ranging from 99 F to 100.4 F.
My mother has been diagnose...-1 My mother has been diagnose...-2

A:   Hello
Welcome to Ask The Doctor.

We are here to help you.
Since she was started on Anti Tubercular Treatment ( ATT ) for Pott's Spine, she developed ATT induced Hepatitis.
Your doctor has done absolutely right. In such scenario, R-Cinex and Pyrazinamide are withheld and Ethambutol and Levofloxacin are used in such cases. Low dose rifampicin can also be added.
Once his liver functions normalize, then all the drugs will be introduced back one by one at low doses.
So, the same has been done by your doctor. You just need to keep a watch on her Liver Functions.
As far as fever is concerned, the response would be evident after 2-3 weeks of complete Antitubercular therapy. Gradually her fever will get back to normal.

I hope it helps.
Stay Healthy.

Comments / Follow Ups

Patient: Thank you for your advice. It means that our treatment is going fine. One thing i want to ask is related to her back pain which is very severe. She has to take 1/2 Combiflam in the morning and 1/2 combiflam in the evening. We were concerned if taking 1 combiflam daily will have any adverse effect? She also tried painkiller like Ultraset but that is not at all effective in reducing the pain. Any suggestion on the pain killer and by when her pain will be reduced?

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