A patient came to me with a history of fever, cold and cough for more than a week not responding to treatment taken outside. The following investigations were done. Blood CBC ESR X-RAy chest.The counts were normal, ESR was 100 and X-ray Showed old fibrotic lesion in the left base. In the meantime I had put him on Amoxicillin, A combination of Vit B1, Calcium Pantothenate, Nicotinamide, Vit B12, Vit B2, Vit B6, Vit C and cough syrup. He improved to some extend.

the fever subsided and he felt better. But What worried me was his lung findings and high ESR.He came back to me yesterday with a history of weakness. His weight had fallen further by 3Kgs.When Going into history once more he did state that he had Kochs in childhood.I have asked for sputum AFB and waiting for the reports. My question is  Is it a relapse of Kochs and if so should we start anti-Kochs treatment and the 2nd line…