### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
My age is 41, I have +ve montox test 12x15mm, tested 16 years back also was almost same. Resently I suffer from hemospermia ( not fresh blood ), so gone through many tests like ultrasound scrotum , TRUS, MRI pelvis seminal vessels , semen DNA PCR, quantiferon gold for TB, semen culture, X-ray chest , & last micobecterium semen culture. 1) DNA PCR result is inhibition detected. 2) MRI shows left side seminal vessel is small & atrophic & reveals hypo intense signals intensity on T2W/ STIR image, few small Hyperintence foci are also seen within the seminal vessel on T1W images most likely hemorrhagic foci . The AP diameter measures 6mm rest all is ok 3) quantiferon gold test is positive. 4) mycrobecteum semen culture 2nd week test is negative. 5) ESR is 03. I was prescribed AKT4 for tb My prob is that should I wait for 4th & 6th week test of Mycobecterium semen test reports or start AKT4 Hemospermia happened first 2 months back.

### output:

Hi, Thanks for using Chat Doctor, You have a positive history of tuberculosis in the past as you have a positive manitou test but there is no recent signs of infection. Present manitou size is similar to older one, your ESR is also very low. As far as MRI is concerned, in active infection the size should increase, but your seminal vesicle size has decreased and become small. Also, the mycobacterium culture is negative till now. I strongly feel you should wait for the 4th and 6th week results before starting the medicine. Hemospermia may be due to some other causes also other than TB. Hope it sorts your problem.