To Your Good Health: Tuberculosis Concerns Are Put to Rest With Test
Dear Dr. Roach: I am 22, and I am a security guard at a local store. Just recently, I detained a suspect for shoplifting.
We were in a room no bigger than a small office, and she was coughing up a storm. I was in and out of the room for a half-hour or so.
When the local police department showed up, she revealed that she has active tuberculosis.
I did my research, and it is contagious when it’s airborne. How much exposure is necessary to catch it? What are the symptoms of TB? Is it curable?
Please, I’m in need of answers. — E.A.M.
Answer: Tuberculosis is an infection caused by the bacteria Mycobacterium tuberculosis.
The most common body location is the lungs, but tuberculosis can infect the kidneys, lining of the brain, bones and lining of the heart, among others.
It is contagious by air only when in the lungs, as you said.
The major symptom is cough, but weight loss also is frequent in advanced stages, giving TB its old name, consumption.
The likelihood of getting infected after exposure depends on many factors, including some things we don’t know in this case, such as whether she is being treated and whether she has cavities in her lungs.
The good news is that you would be considered a low-risk contact, having been in a room with her only for a relatively short period.
The bad news is that it is possible to have acquired an infection.
Your doctor or a public health official should evaluate you for evidence of prior infection with a skin test, which should be repeated in eight to 10 weeks.
Tuberculosis is almost 100 percent curable.
People with active infection usually are treated with several medications for six months.
Dear Dr. Roach: My wife drinks in excess of three liters of diet soda a day, sometimes even more.
She has colitis, for which she takes Lialda, and on her last visit to her primary care physician, her blood work revealed borderline bad levels in her liver.
The doctor seems to think she needs to stop “drinking alcohol,” but I have been married to her for more than 30 years, and I know it’s not drinking that is causing this.
We both consume only moderate amounts of alcohol.
Could it be the chemicals in diet soda? — F.J.R.
Answer: Three liters a day is a lot of diet soda, and that much caffeine probably isn’t good for her.
However, I don’t think it is likely to be affecting her liver.
Mesalamine (Lialda and others) rarely can cause abnormal liver tests — specifically, high levels of the same enzymes that might lead a doctor to suspect alcohol use.
You didn’t tell me what kind of colitis your wife has, but ulcerative colitis, a form of inflammatory bowel disease, is associated with several kinds of liver problems, including fatty liver and primary sclerosing cholangitis, which is potentially severe.
I don’t think either alcohol or diet soda should be blamed until she has had a more careful workup.
I think a visit with her gastroenterologist would be wise.
Dear Dr. Roach: I injured my little finger in an athletic event. The end of my pinky finger pointed in toward the ring finger. It is black and blue, and swollen. Do you think I fractured it? Should I get an X-ray? I am still able to curl my finger. — A.J.
Answer: It’s most likely that you damaged one of the tendons in the finger. Sometimes a fracture can happen at the same time.
Most often, these are treated conservatively, with ice right after the injury and the finger splinted in a straight position for up to six weeks.
Only an experienced physician, such as a hand surgeon, can provide exact recommendations for you.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible.
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