Primary Complex Thread 2

[leletmd]

^ Pasensya na, but since your pedia is the one who is most knowledgeable about your child's health, I think you should follow her advice. It would be unethical for me na pakialaman ang milk and vitamins na bigay ng pedia mo.
It is possible that your son has reached a plateau in appetite and weight gain. How old is your son? What is his ideal weight and what is his weight now? Two kilos weight gain in one month is really a lot so I think medyo babagal ang weight gain niya after that. For kids 1 years old and above, the normal weight gain is 2 kilos in 1 year.

[clyveDC]

Hi girls.. need your opinion regarding Central Pneumonitis same lang ba un ng Primary Complex?

Do you have any idea?

[myjoy]

hi doc! thank you po for your reply. right now, nag gain muna si baby and after a week kapag hindi umayos, we're switching to pediasure naman.
binigyan din sya ng probiotics capsules as his vitamins.
bumaba po kasi yung timbang nya ulet ng .8 kilos in one month.
he's 14 months old and he weighs 11 kilos now.

[leletmd]

@clyveDC:
Pneumonitis is different from PC. Try to back read since your question has been answered several times in this thread already.

@myjoy:
11 kgs is within the ideal weight of a 14 month old. Ideal weight for a 1 to 2 year old child is 10 to 12 kgs. What is his height? Is his weight within the norms for his height? Mas important kasi ang weight for height rather than weight for age.
Hindi vitamins ang probiotics. It is a supplement containing good bacteria that helps enhance our immune system. Walang Vitamin B complex or vitamins C, A, D or E in any probiotic preparation.

[ankyneMD]

hello sises at doc lelet.. Thank you po sa reply

[myjoy]

thank you po for patiently answering my questions doc lelet! 
his height is 30 inches now. i just had him checked a week ago. hindi ko po binilhan ng probiotics si baby kasi naaawa na ako sa dami ng gamot na iniinom. kasi aside from hrz pedia, pag sinipon si baby, azythromycin agad ang reseta. parang nasosobrahan na ata ng gamot.
pinabigyan ng mom ko ng subok na daw na tiki tiki...lumalakas na ulit sya kumain ngayon pero medyo mahina pa din sa milk. i'm trying out different brands now to see kung ano naman ang magugustuhan nya.
he looks payat pero mabigat sya pag binuhat. pero gusto ko sana hindi seesaw yung timbang nya. kasi aakyat ng ilang kilos tapos pag nabawasan, 1 kilo din agad.

[leletmd]

@myjoy:
I don't think you have to worry so much about his weight. His weight is within the ideal range for his height naman.
In my opinion, I would rather prioritize fixing his eating habits than giving all sorts of vitamins or experimenting with different kinds of milk since at your son's age, milk should no longer be his main source of nutrition. Most of the time, it is not the milk nor the vitamins that is the main problem, but the eating habits...
Also, if he is on antibiotics all the time, then probiotics will help restore balance to his immune system. I would rather give this than vitamins...

[cerelina]

Hi dra my baby is now 5 months as of may 26, her last check up was on may 2 she weighted 5.5kg  and today she had her check up she now weighs 6kg. Based on her weight she was just 2kg when born during the first 2 months tag 1kg yung weight gain nya when she reached her 3rd month tag .5kg na lang. I told her pedia na parang may mga bukol behind her ear her pedia suspects na primary complex daw he reviewed baby's weight gain for the past 2 months she was gaining 1kg per month then the third month onwards puro 0.5kg na lang.  He did the skin test to be analyzed on Saturday, is there really a possibility na primary complex nga po yun? Yung mga kulani behind her ears can it be indication of other infection or PC lang po ba talaga yun?

Another question po is it possible to have a false positive result due to bcg vaccine since she's only 5 months.

Thanks po

[rhylie10]

good day po dra. lelet, nagpost po ako ditto last may 3, yung sabi po ng pedia ng anak ko ok naman yung result ng -xray ng anak ko, pero kahapon po pinacheck up ko po ulit sya kasi po inubo nanaman last Saturday until now at nilagnat po nung Monday until Wednesday, when I asked her pedia yesterday about the x-ray sabi po nya di daw nakita if may primary kasi po masyado maplema daw po yung baga, pero nung may 3 ang sabi nya ok naman daw, tapos kahapon biglang ganun, niresetahan po siya gamut, pediahclor, procaterol, disudrin, and celestamine, bale 12 days po lahat inom ng gamut, 7 days yung sa pediahclor then celestamine after ng disudrin for 5 days, and then after po inom gamot at nebulization balik po kami at gagawin na daw po yung skin test. sana po nung may 3 palang sinabi na di pa sure yung sa x-ray.. ask ko po bakit dalawang anti-biotic po? pediahclor at celestamine? tia

[rhylie10]

ok lang po ba yung 2 anti-biotic? sabi po kasi nila masama din daw po puro anti-biotic, monthly nalang may resetang ganun, mas ok po ba pag nilipat ko sya sa pedia-pulmo?

[insta_momma]

hi dra., my 6 months old baby laging umuubo since he turned 5 months. I don't really think he has cough, pag ubo niya kasi every time we feed him or kapag may gagawin sa kanyang ayaw niya. Is it possible na ang pag ubo niya is a way of telling us na ayaw niya? hindi ko talaga ineentertain yung thought na it might be something serious, more of naging habit na kasi ng baby ko pag ubo. he doesn't cry a lot, most of the time dinadaan niya sa pag ubo. tulad ng kapag iniwan siya sa crib, he'll cough and parang he knows na kakargahin naman siya when he does that. when we feed him milk uubo ulit and he knows aalisin namin bote. possible kaya na ganun yun? when his pedia checks wala naman daw ubo and clear daw lungs.

[leletmd]

@insta_momma:
Is it really cough or just throat clearing? Do you feed him while he is lying down? Hindi ba siya nasasamid while bottle feeding?

@rhylie10:
Celestamine is not an antibiotic. It is composed of an anti-histamine combined with a steroid (chlorphenamine plus betamethasone). Chlorphenamine is a 1st generation anti-histamine while betamethasone is a steroid.
Pediachlor is the antibiotic, not celestamine.
Were you able to follow up with your pedia last May 3 as I previously suggested to clarify the previous chest x-ray results? 
Were you able to get the official reading of the chest x-ray done last May 3? If not, please get the official reading as well as the chest xray plates from wherever the xray was done so that you can find out what the official chest x-ray assessment was.

@cerelina:
Enlargement of the lymph nodes behind the ears may be due to infection in the ears, nose, mouth area. It seldom pertains to PC since for PC, it is usually the cervical (neck) lymph nodes that enlarge.
For BCG vaccinated patients,  a size of the PPD induration > 10 mm is considered positive.

@ankyneMD:
Regression means that his TB infection is improving and he is responding to the meds.

[rhylie10]

goodeve  dra.lelet, thanks po huh, kauuwi ko lang po galing CGH, humingi po ako ng copy ng result ng x-ray nya nung may 1, yung pedia po kasi nya di ako binigyan at di rin inexplain, eto po nakalagay sa result ng x-ray nya
1. Streaky infiltrates are seen in both lung fields.
2. Enlarged tracheobronchial lymph nodes are noted.
3. Heart is not enlarged.
4. Diaphragm is flattened posteriorly.
5. Both costophrenic sulci are intact.
IMPRESSION: Bilaterial Pneumonia with Lymphadenopathy and air trapping.

dra. lelet ano po ibig sabihin ng mga yan? di po kasi talaga inexplain ng pedia nya sa chinese yung about sa x-ray, di rin po ako binigyan ng copy, sa radiology section lang po ako humingi now.. tia po..godbless

[rhylie10]

yung result lang po nakuwa ko, yung plates po hindi.. paexplain naman po yung nasa post ko about dun sa result ng x-ray nya..di po inexplain ng pedia nya yun ehh..tia po..sensya na po

[rhylie10]

yung sinabi po nyong ifollow up check up sya, kasi po tinawagan ko po yung pedia kung babalik pa po ba kami sa kanya, sabi nya no need na daw bumalik kasi ok naman daw po yung x-ray nya..

[leletmd]

@rhylie10:
The chest xray findings you posted points to Pneumonia as a possible cause of your child's symptoms during the time the chest x-ray was taken/done. Air trapping and flattening of the diaphragm may also be seen in cases of Asthma and viral infections such as bronchiolitis.
Pneumonia is a different disease from TB or PC, although there are cases wherein TB may cause Pneumonia.
Since your child's symptoms have been going on for quite some time, I suggest a consult with either a pedia pulmo or a pedia Infectious disease specialist.

[cerelina]

Thanks po we got ourselves checked na rin po para sure her skin test is lightening na po mas swollen pa one day after the test now that it has been almost 72hrs medyo nag lighten and nabawasan yung maga

[rhylie10]

morning mo dra. lelet, thanks po huh, plan ko rin po talagang ilipat sya sa pedia pulmo.. yung dati po nyang pedia tinext ko rin po kagabi sabi nya nga po pneumonia daw, balik daw po kami sa kanya dalin yung plaka ng x-ray .. di aman po kami binigyan nun..yung papel lang po na may result.. sa 14 po gagawin yung skin test nya dun po sa pedia nya sa cgh, after nalang po siguro nung skin test nya lipat ko sya ng pedia. thanks po talaga..

[leletmd]

@cerelina:
The induration (matambok na part) at 48 to 72 hours is the one that should be measured, not the red part.

@rhylie10:
You can ask the radiology department of the hospital for the chest xray plates. It is better to evaluate the plates kasi rather than just rely on the official reading of the radiologist.
Perhaps it would be better to seek the 2nd opinion first before having the PPD done.
PPD kasi would just determine presence of exposure and not actual disease. Chest xray pa rin ang kailangan to determine if the child has pulmonary TB.

[cheezecake]

ask ko lang ano ba ang normal range ng TB, DB,IB sa bata?  Is there a chance na normal ang blood test pero swollen ang liver?  Thanks po