Dear Doctor, 

I had a cough recently and was given amoxyl. My health improved, but I developed chest pain a few days ago. My family says I might have TB. I am worried, what should I do?

Nashiba

Dear Nashiba,

What was the duration of cough? Was there associated fever, night sweats and or reduced appetite? These are symptoms of TB. If the cough has improved with amoxyl and there is no fever or constitutional symptoms, TB is unlikely.

The chest pain may simply be muscular pain caused due to exposure to cold or heavy physical work. Infections of the lung tissue causing pneumonia or of its cover the pleura, can cause chest pain. But in this case there would be fever and productive cough along with chest pain. The pain tends to aggravate with inspiration.

One can have chest pain due to dyspepsia or inflammation of the stomach mucosa, i.e. inner lining. This pain is often burning in nature and associated with nausea and or vomiting. Binge of alcohol tends to precipitate and aggravate this pain. Pain relieving medicines like Ibuprofen, aspirin, also tend to cause such pain. Viral infection like herpes zoster can cause severe burning pain over the affected area. Vesicular eruptions emerge over that part, 2 to 3 days after the pain starts.

Mental stress can cause pain in the upper chest, over the junction of breast bone with ribs.

Complete blood count if done can point if there is some underlying infection, X-ray of the chest would reveal any problem in lung tissue. Any underlying cause of chest pain is curable.

Dr Rachna Pande  is a specialist in internal medicine at Ruhengeri Hospital