Primary Complex Thread 2

[mommyniuja]

@leletmd sis ask ko lang ano ba ibig sabihin nito?

Right paratracheal infiltrates r/o PTB please secure old films for comparison.
Rest of lungfields are clear.
Heart is not remarkable.
Bony thorax is intact.

Thanks in advance.

[syra_chloe]

@leletmd, hi doc good news, negative yung skin test ni baby so...hindi na kami maggagamutan... salamat sa info ha...

[leletmd]

@syra_chloe:
You're welcome. It's good to know your baby is negative for PC

@mommyniuja:
Adult patient ba ito?
It just means that there were secretions noted at the paratracheal area that may be due to PTB. The radiologist wants to see previous plates to check if it is due to TB or due to something else.
Kailangan pa rin icorrelate clinically with signs and symptoms of the patient.
If adult patient, better if pagawa ng AFB smear and culture on 3 consecutive days.

[mommyniuja]

@mommyniuja:
Adult patient ba ito?
It just means that there were secretions noted at the paratracheal area that may be due to PTB. The radiologist wants to see previous plates to check if it is due to TB or due to something else.
Kailangan pa rin icorrelate clinically with signs and symptoms of the patient.
If adult patient, better if pagawa ng AFB smear and culture on 3 consecutive days.
[/quote]
hi sis! adult patient po yan. thanks po sa info.

[iceylicious]

bawal ba kumain ng eggs pag meron nito?? yung mga malalansang food

[leletmd]

Walang food na bawal kainin ang patient na may PC/TB unless there was a previous history of allergy to a specific food item.

[joyce09]

@ doc leletmd

Hi doc, i need your some input regarding my son's health condition... My 2yr-old son had his x-ray last week pina x-ray po siya kasi sabi ko sa pedia niya minsan napapansin ko na parang ang lalim ng hininga niya. The x-ray results ang left heart medyo nag enlarge so pina ecg din siya to compare the result from xray and it's noted that lungs are clear . the ecg results sinus trachaecardia mabilis daw heart rate ng rigth heart left heart is normal. we referred to pedia cardiologist. nung kinuhanan ng heart rate son ko thru stethoscope nasa normal range naman maaring dahil crying daw son ko during ecg test kaya bumilis daw heart rate niya. the pedia cardiologist asked me kung gusto ko daw ipa 2d echo pra mkasiguro na ok ang heart ng son ko i said yes. the result was normal maliban sa pulmonary (di ko po maalala ang exact na explanation) media mataas daw ng konti lang naman. since may son has a history of PC last year tiningnan niya ang xray plate ng son ko to compare doon sa findings na sinulat sa result. sabi niya parang may nakikita daw siya na kumpol kumpol na white, hindi naman ubuhin or sipunin pero mabilis siya mag accumulate ng phlegm pero clear phlegm po siya at nakakapa niya meron mga kulani sa neck ng son ko.  she suspects na kaya malalim minsan ang hininga ng son ko dahil sa resperatory problem since clear na di dahil sa heart. since may history po siya ng pc before kaya ang lungs ng son ko is weak.  then painumin ulit son ko ng comprilex at ripamed for 3mos titingnan po kung may development. and catopril para doon sa pulmonary na sinasabi based sa result ng 2d echo.

doc ang concerned ko po ok lang po ba ang ganun ano ang maaaring side effect pag uminom ulit son ko ng gamot for pc for 3mos. awang awa ako sa son ko dahil at very young age dami na niyang antibiotic na iniinom. no choice rin ako kung yon ang makakabuti sa kanya ang worried ko lang talaga yung maaaring side effect sa son ko sa pag inom ng mga reseta sa kanya. di kaya maapektuhan ibang organs niya.

please enlighten me doc lelet para ma lessen po ang worries ko. thank you.

[leletmd]

@joyce09:
I hope you can clarify lang some things...

@ doc leletmd

Hi doc, i need your some input regarding my son's health condition... My 2yr-old son had his x-ray last week pina x-ray po siya kasi sabi ko sa pedia niya minsan napapansin ko na parang ang lalim ng hininga niya. The x-ray results ang left heart medyo nag enlarge so pina ecg din siya to compare the result from xray and it's noted that lungs are clear . the ecg results sinus trachaecardia mabilis daw heart rate ng rigth heart left heart is normal.

Saan na note na clear ang lungs? Hindi kasi ito makikita sa ecg. You can only compare the heart findings of the x-ray from the heart findings of the ecg.

Phlegm or fluid from the lungs can be coming from either the heart or the lungs in itself. Did the cardio clear your son as having no heart problem? So ang suspicion niya is sa lungs mismo nanggagaling ang phlegm?
My suggestion would be to seek a second opinion from either an Infectious disease specialist or a pulmonologist para madetermine talaga saan nanggagaling ang phlegm or if there really is a need to treat again.

[joyce09]

@doc lelet:

Saan na note na clear ang lungs? Hindi kasi ito makikita sa ecg. You can only compare the heart findings of the x-ray from the heart findings of the ecg.

Phlegm or fluid from the lungs can be coming from either the heart or the lungs in itself. Did the cardio clear your son as having no heart problem? So ang suspicion niya is sa lungs mismo nanggagaling ang phlegm?
My suggestion would be to seek a second opinion from either an Infectious disease specialist or a pulmonologist para madetermine talaga saan nanggagaling ang phlegm or if there really is a need to treat again.

yes doc the cardio clear my son as having no heart problems. siya na mismo ang nagperform ng 2d echo sa son ko. yung clear lungs noted po iyon ng radiologist kinuha po ng cardio ang xray plate para makita niya mismo.  yun na nga sabi niya parang may kumpol kumpol na white at may kulani kasi son ko sa leeg at parang weight niya may tataas may bababa so parang doon lang mismo sa range na iyon. although di siya underweight sa age niya. 2yrs old siya last july29 weigh niya 12.5kilos height niya 91cm. napansin ko rin na parang di nag gegain siya ng weight since march.

sige po doc maghanap po muna ako ng infectious disease dr. bago ko painumin ulit ng gamot for pc. dapat magstart na siya this morning. thanks po doc.
 

[leletmd]

@joyce09:
I suggest you also follow up with your main pedia so that she will be informed of the cardio's findings and baka may iba rin siyang suggestions.

[joyce09]

@ doc leletmd:

Doc i brought my son today to a pediatric pulmonologist naghahanap po ako ng pediatric Infectious disease doctor pero nauna kong nakita ang pulmonologist doctor. I told her the medical history po ng son ko. kinapa din po niya ang leeg ng so ko and I relate to her kung ano ang presumption ng cardio doctor sa case ng anak ko tungkol sa phlegm na maaari dahil sa primary complex pa niya dati. Pero ang explanation ng pedia pulmo di daw talaga nawawala kaagad ang mga kulani at kahit na treat na daw ang pc pag pina ppd daw turns out positive parin and it takes years daw iyon bago maging negative. sabi niya maliliit naman daw ang kulani sa leeg ng anak ko at natural lang talaga na may mga lymph nodes. regarding naman sa weight ng anak ko normal naman daw sa ganun age niya at 1-2kilos in a year lang daw ang magain nila sa bracket ng age ng son ko. she advised me not to give my son another med for pc and instead she prescribed montelukast (singulair) for 2weeks then follow up after 2weeks kasi baka sa allergy kasi may history son ko ng atopic dermatitis nung infant palang siya. pinapatigil narin niya sa akin ang catopril na reseta ng cardio kasi pinakita ko ang result ng 2d echo ng son ko sabi niya ok lang naman daw.

thanks doc for your suggestion na mag seek ako ng 2nd opinion ng specialist doctor (infectious disease/pulmo) ngayon medyo panatag ako kasi di na paiinumin anak ko another pc meds. pwedeng allergy nga kc minsan atching ng atching son ko usually sa morning pag nagising siya nagkakaroon siya ng dry cough at minsan meron dark circle sa eyes niya.

yes doc follow up ko son ko sa main pedia niya although na inform ko siya na normal ang 2d echo ng son ko pero di pa niya alam na request ng pedia cardio take ulit ng pc meds son ko.

thanks doc lelet for always there to answers all our concerns.

[leletmd]

@joyce09:
It's a good thing you were able to clarify it with the pedia pulmo. From your earlier posts kasi, your son's cough seemed more allergic than a recurrence of the TB infection.
And yes, tama ang pedia pulmo to say that it takes years for the PPD to become negative, lymph nodes to decrease in size, etc.
Also, all normal healthy people have lymph nodes all over their bodies. Lymph nodes are part of the immune system and they function in antibody production. They enlarge and become palpable when they produce antibodies in response to infection, wounds, allergies, etc.
If a person has been found not to have any lymph nodes at all, then that person has immunodeficiency and cannot fight infections.

[swt_fem]

Joining!

My son was diagnosed with PC 2 months ago, naka Kidz Kit 3 kami at first then after 2 months, Kidz Kit 2 na. Sakitin kasi ang son ko, laging may ubo't sipon and he's barely gaining weight. Nagpunta ako sa pedia pulmo at Makati Med, 'coz he was sick again. Nag meds lang kami like Ventolin, etc. After a week, nag suggest na si doc to have a PPD test. After 48 hours, we went back and the pedia measured the circumference and my son was positive with PC. 14mm. Ang tagal bago nalamang may PC ang son ko from his previous pedia. Una, baka asthma daw or some type of allergy kaya nagdecide narin ako magpalit ng pedia noon.

After that check up, pina-xray agad and luckily negative naman ang xray. Well, I should say it's much better kasi pag positive din sa xray, mas matagal atang gamutan.

4 months to go! My son just turned 1 year old 2 weeks ago and he's only 10 kgs. Nung hindi pa sya sakitin, 800g to 1kg ang nagegain nya every month, ngayon... haaayyy...

[leletmd]

@swt_fem:
Did the pulmo clarify why your child was given 3 meds when the chest x-ray was negative? Meron pa bang ibang criteria na nafulfill?

After that check up, pina-xray agad and luckily negative naman ang xray. Well, I should say it's much better kasi pag positive din sa xray, mas matagal atang gamutan.

4 months to go! My son just turned 1 year old 2 weeks ago and he's only 10 kgs. Nung hindi pa sya sakitin, 800g to 1kg ang nagegain nya every month, ngayon... haaayyy...

Clarify ko lang na iba kasi ang treatment kapag PPD positive and chest x-ray negative sa PPD positive at chest x-ray positive.
Kapag PPD positive and chest x-ray negative, usually 1 to 2 meds lang ang ibinibigay at 6 to 9 months ang gamutan. Exposure lang kasi ito at nakagawa ang immune system to contain the spread of PC.
Kapag 3 criteria ang nafulfill (including Positive PPD and chest x-ray findings indicative of PC), 3 meds ang ibinibigay during the first 2 months then 2 meds for the next 4 months.
Baka may ibang nafulfill na criteria ang son mo kaya his symptoms were treated as disease and not as exposure.
I hope you are able to find the source.

[joyce09]

Clarify ko lang na iba kasi ang treatment kapag PPD positive and chest x-ray negative sa PPD positive at chest x-ray positive. Kapag PPD positive and chest x-ray negative, usually 1 to 2 meds lang ang ibinibigay at 6 to 9 months ang gamutan. Exposure lang kasi ito at nakagawa ang immune system to contain the spread of PC. Kapag 3 criteria ang nafulfill (including Positive PPD and chest x-ray findings indicative of PC), 3 meds ang ibinibigay during the first 2 months then 2 meds for the next 4 months. Baka may ibang nafulfill na criteria ang son mo kaya his symptoms were treated as disease and not as exposure. I hope you are able to find the source.

Doc, what if kung PPD positive and xray negative but 3meds ang binigay for 2mos and 2meds for the last 4mos. ano po ang maging side effect esp. if baby palang ang patients?

[swt_fem]

@swt_fem:
Did the pulmo clarify why your child was given 3 meds when the chest x-ray was negative? Meron pa bang ibang criteria na nafulfill?

Clarify ko lang na iba kasi ang treatment kapag PPD positive and chest x-ray negative sa PPD positive at chest x-ray positive.
Kapag PPD positive and chest x-ray negative, usually 1 to 2 meds lang ang ibinibigay at 6 to 9 months ang gamutan. Exposure lang kasi ito at nakagawa ang immune system to contain the spread of PC.
Kapag 3 criteria ang nafulfill (including Positive PPD and chest x-ray findings indicative of PC), 3 meds ang ibinibigay during the first 2 months then 2 meds for the next 4 months.
Baka may ibang nafulfill na criteria ang son mo kaya his symptoms were treated as disease and not as exposure.
I hope you are able to find the source.

Doc, ano po yung 3rd criteria? Wala naman po kasing nabanggit yung pedia pulmo. 3 meds kami for the first 2 mos then 2 meds nalang ngayon. Negative talaga ang xray pero positive sa PPD (14mm).

Negative kaming family sa xray, I think ang nanghawa was yung 1st yaya nya. Pero hindi na naman masisiguro kasi wala na po samin.

[leletmd]

@joyce09:
Possibility of resistance and/or allergy to the meds when there is a need to treat during re-exposure

@swt_fem:
Check this link:

http://www.femalenetwork.com/girltalk/index.php/topic,238463.20.html

I posted the 5 criteria there. Check mo na lang kung ano ang na-fulfill ng son mo. You need to fulfill 3 out of the 5 criteria to be able to diagnose disease.

[leletmd]

^ Probably no need to repeat the PPD test, but I suggest you mention the blood clot to your pedia when you go for reading tomorrow. Make sure also that you don't press on the area. Don't put cream/ointment on the area.
Also, kahit newborn baby pwedeng i-xray as long as there is a clinical indication for it...

[andreil_19]

Ano po ba yung CLAD doc?may medical check-up sa school ng daughter ko at yun ang nakalagay na illness sa form nya then doc suggested for PPD.kinapa ko leeg nya wala naman akong nakapa na kulani and magaling na rin cough and cold nya.last week of august kasi nagkarun sya ng low grade fever then colds and cough pero nawala rin nung pinainum ko ng ventolin.concern ko now is her weight nabawasan kasi although this week slowly bumabalik appetite nya.

[leletmd]

^ CLAD = cervical lymphadenopathy or lymph nodes/kulani at the neck area
Technically speaking, it is not an illness but a medical finding. We all have lymph nodes all over our body but normally, hindi ito nakakapa. Once there is an infection or allergy or inflammation like sa sugat or dental caries, the lymph nodes will produce antibodies causing its' enlargement and doon siya nakakapa.