JAUNDICE and RING ENHANCING LESIONS in CT brain.

Resolved question:
The Girl age abt 27 years old patientweight 34 KG suffered from vomiting. It May be noted that just before 15 days she was having fever etc and diagnosed to have swelling on Gol Bladder and 15 days medicine was given with 1 week hospitalization. Now Doctor advised for CT scan and MRI. The report conclusion Multiple ring enhancing granulomas in the bilateral cerebral cerebellar hemisphere and pons with mild to moderate perilesional edema, Morphological feature are consistent with Tuberculoma. Before CT Scan / MRI Report doctor prescribed her following medicine which was give for around 3 days :
Inj Nurokind Gold
Inj. EwSet 8mg
Inj PAN 40 mg
Inj Stemetil
Reinflow No
After three days she was unable to stand on her feet. She can able to talk, sit but want be able to walk and Stand without support .
Is it side effect of any medicine? Why She want be able to stand on her feet without support? How long it will take her to recover completely apart from taking medicine for long.
After CT scan and MRI report doctor gave here below Medicine –
Inj . Dexa 8 mg,
Inj Mannitol 100 ,
Inj Levela 500mg,
Inj Antristrin 0.5 mg,
Tab. Akurit,
Tab. Combuton 800,
Tab. Pyzina 1000,
Cap. Neksium 40 mg,
Tab. Domstal

It may be noted that her weight is abt 34 kg with absolutely fine health since long . She was admitted for Fever and weakness on 31/07/2014 and there  about a week. After that she was fine. Later on after about 15 days she complained about continuous vomiting there after CT Scan and MRI done and treatment started as above . that time Haemoglobin was 9.5 gms , ESR at the end of one hour 70 mm Method Westergren, S.G.O.T Per liter 55.9 units , S.G.P.T. Per liter 53.8 units. Microscopic examination of Centrifuged Deposit - Pus cells 01-02 / HPF, Epithelial Cells 02-03/ HPF, Red Blood Cells 00-00/ HPF. First she was diagnosed for jaundice and than swalling on Gol Bladder. 

Submitted: 4 Days
Category: Neurologist, Medical

Expert:  Dr. Sudhir Kumar replied 4 Days.

Hello.
Thank you for posting your query at DoctorSpring.com
I have noted the details of the patient Mrs Anupama. I have also seen the reports of her CT and MRI brain.
The reports are suggestive of brain TB infection.
At present, she is getting correct treatment, which includes medications to cure TB (tuberculosis). As there is swelling in the brain, she is also getting steroids and mannitol to reduce the swelling.
In addition, she is also receiving anti-epileptic medications, to reduce the chances of seizures.
Please note that TB medications should be continued for 18 months (one and a half years).
She would gradually improve.
I hope it helps.
Best wishes,
Dr. Sudhir Kumar MD (Medicine), DM (Neurology)
Senior Consultant Neurologist

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Patient replied :

Dear sir,
Thank you very much for you kind response. Sir my query is:
After first three days of tratment i.e. before CT scan and MRI , she was unable to stand on her feet. She can able to talk, sit but want be able to walk and Stand without support .
Is it side effect of any medicine given before treatment of TB? Why She want be able to stand on her feet without support? How long it will take her to recover completely apart from taking medicine for long.
Thanking you in anticipation.


Expert:  Dr. Sudhir Kumar replied 3 Days.

Thank you for getting back.
Her symptoms are not due to the side effects of any of the medicines taken before the scan (they are commonly used and safe medicines).
She has difficulty in standing and walking because of brain TB.
She would start getting better within a month and her improvement would continue slowly after that.
Best wishes,
Dr. Sudhir Kumar MD (Medicine), DM (Neurology)
Senior Consultant Neurologist

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