[Lymphoma Cancer]Common symptoms of pulmonary tuberculosis induced by decreased immunity during treatment: cough, fever, night sweat, weight loss (medical advice) – Ming Pao Health Network

[Ming Pao News]66-year-old Mr. Wang was recently diagnosed with highly toxic diffuse large B-cell lymphoma. The treatment regimen included the anti-B-cell monoclonal antibody rituximab, plus a variety of chemotherapy drugs. Mr. Wang responded well after receiving the treatment, and the lymphatic tumor receded rapidly. It is estimated that the chance of cure is quite high. During the treatment, Mr. Wang suddenly continued to have a low-grade fever, and was finally diagnosed with pulmonary tuberculosis. He needed to receive anti-tuberculosis drug treatment at the same time. The drug for treating lymphoma reduced Mr. Wang’s immunity, and the latent tuberculosis bacteria in the body became active, leading to tuberculosis.

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Treatment of lymphoma, decreased immunity, induced common symptoms of tuberculosis: cough, fever, weight loss

Tuberculosis is a local endemic disease, and there are still many new cases every year. Many Hong Kong people have been infected, but they do not necessarily develop the disease immediately. Mycobacterium tuberculosis can be latent infection in the human body for a long time without any symptoms. However, when the immune system is weakened, it may become active infection and induce various symptoms. Hong Kong people immigrate to foreign countries, and many countries require them to undergo a medical examination before leaving Hong Kong to rule out tuberculosis infection.

Tuberculosis affects the lungs and can infect the lymph nodes, brain, kidneys, bones

Tuberculosis affects the lungs more, especially the upper lobes where oxygen levels are low. Common symptoms include cough, fever, night sweats, and weight loss. Chest X-rays and chest computer scans are helpful for diagnosis. Tuberculosis can also infect other organs and tissues in the body, including lymph nodes, brain, kidneys, bones, and the pleural cavity.

If a patient is suspected of having an active tuberculosis infection, the sputum can be tested first to check for the presence of tuberculosis bacteria. Using Ziehl-Neelsen stain to detect acid fast bacilli can help confirm the diagnosis. The sputum of most patients only contains trace amounts of TB bacteria, which are not easy to detect. Therefore, it may be necessary to culture the bacteria in the laboratory, or use genetic technology to detect the TB gene. Helps make a quick diagnosis. Other tests include bronchoscopy and lung biopsy. If other organs of the body are suspected to be infected with TB, a biopsy should also be performed; pathological analysis may show necrotizing granuloma containing Langhans giant cells; Helps early and accurate diagnosis.

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Medication must be taken under medical observation

To treat tuberculosis, patients must take multiple anti-tuberculosis drugs at the same time to avoid drug resistance. Tuberculosis is an infectious disease. The Hong Kong Public Health Ordinance requires doctors to report all active tuberculosis cases to the Department of Health. In order to ensure that all patients take their medicines on time and avoid the emergence of drug-resistant bacteria, the Government Chest Clinic requires all patients to take anti-tuberculosis drugs regularly under the observation of clinic staff, and to monitor the side effects of the drugs. The DH will also proactively seek out close contacts of the patient and arrange necessary TB tests for them.

At present, everyone is more concerned about the new crown virus, but still be careful of tuberculosis.

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Text: Leung Hsien Sun (Specialist in Hematology and Hematology Oncology)