Primary Complex Thread 2

[leletmd]

^ Not all cases of PC will develop scarring. It depends on the immune response of the patient.
Hindi nakakahawa ng PC or TB ang bata sa bata (Try to back read. I posted the reasons why in the earlier pages of this thread). Ang transmission ng PC or TB is from adult to child.
If it is really PC, though, I suggest that you look for the source of infection (kung sinong adult sa household niyo ang nanghawa sa daughter mo) kasi yung source ang posibleng mag-infect sa baby mo later on kapag hindi nagamot ang source.

[pumngold]

ask ko lang po  kung one sign ang pawisin ang ulo for PC? kasi baby ko has poor weight gain then pawisin ang ulo.

[leletmd]

@pumngold:
Not necessarily a symptom of TB or PC.
Adult patients ang madalas magkaroon ng night sweats as a symptom of TB.

[emv555]

magandang gabi po mga ka-momsy and dra lelet. just ths day my 12 month old baby has a positive ppd result 5mm ata. kidz kit start tom.it broke my heart to find out. ask ko lang po sana DRA LELET if magkarun ng jaundice as side effct nung pc med, [textspeak!] po pwd mangyari. papaulit [textspeak!] bcg nya. ala cya scar sa bcg at birth given. papa ay kami laht to find out thew source. she is taking montelukast. and mosegor for appetite. is it safe enuf for the baby? dami na intake meds and vits. pls enlighten me. maraming salamat and God Bless us all

[leletmd]

@emv555:
What is the exact PPD size? Chest x-ray findings?
If no BCG and the baby is beyond 3 months of age, we do PPD first. If PPD is negative, then BCG may be given. If PPD is positive, then treatment is started and we do not give BCG anymore.
Regarding meds, dosage is computed based on the weight of your baby to prevent side effects such as jaundice. If jaundice appears, the dosage is adjusted.
It is normal to have orange colored urine, tears and sweat when a patient is taking rifampicin. This is a good sign that the rifampicin is being absorbed properly.

[emv555]

Hi dra lelet if am not mistaken it was abt 5mm? reddish pa rin up to nw. no xray yet po. yes color orange nga po pupu and urine. 9.5kgs po cya 12 month old baby girl. 2ml dosage for the 3 meds po. ok po ba eto? tnx po God bless

[fysai]

hi doc lelet! i'm a newbie here.. i need ur advise pls.. my son has primary complex, he started his medication last sept. 30, 2011 (10mos old).. so far my slight weight gain.. from 8.4 (at the time of diagnosis), 8.7 na ang weight nya.. we also changed his milk from alacta to nido 1+.. he just turned 1year old last nov 14..
my prob is, every month my cough siya.. doc is this an indication that nothing is changed regarding his infection? from the day he was born, he was on antibiotics..
december, 2010 nag ka diarrhea siya, antibiotics (ampicillin and gentamycin)..
january, my cough, antibiotics (himox at first den it was chaged to cefexime, plus nebulizer).. february, rashes on his neck and chest (co-amoxiclav),
march, cough (himox changed to cefexime, brochofen)
april, cough  (cefixime, bronchofen)
may, amoebiais (bactille ts, and the rest)
june, cough (cefexime)
july, cough and sipon (himox, disudrin, oregano extract)
august, cough (himox, oregano extract)
september, cough (himox, ambroxol), he underwent PPD, nag positive po siya.. [textspeak!] x-ray po niya lumabas pneumonia
october, cough (himox changed to co amoxiclav, ambroxol)
november, ngaun po just 4-5 days after he finished co-amox, cough na nman..
ano po kaya ang problem doc? on his father's side po kc, asthmatic po.. [textspeak!] cousin niya is sa father side parang same din po sa knya, palaging my ubo and asthmatic..everytime my son has cough, my wheezing talaga.. does this mean my asthma din po ang baby ko?help nman po doc.. naguguluhan na po ako.. my effects po ba [textspeak!] [textspeak!] antibiotics since birth of his poor weight gain? pasensiya po doc, ang haba na nito.. i really really need ur help.. pls.. tnx a lot in advance! god bless u doc lelet!

[leletmd]

@emv555:
Why was a chest x-ray not done? How many medications are being given to your baby? What is the exact diagnosis given? PC or exposure lang?
You need to fulfill 3 out of 5 criteria to be able to diagnose PC or TB. Chest x-ray is one of the essential criteria because that is where you'll be able to see if the child has actual disease or not.

@fysai:
Medyo alarming ang frequent antibiotic intake ng baby mo. Lahat ba raw ng cough niya is baacterial in nature? It is normal for a child kasi to have around 8 viral upper respiratory tract infections/year. Viral infections clear up on its own. Hindi kailangan ng antibiotics if it's a viral cough.
Why was he given antibiotics for rashes?
Early antibiotic intake is one of the risk factors for allergy development. Antibiotics kill not only bad bacteria, but also the good bacteria  (probiotics). Probiotics are needed for normal immune system development and it shifts the pathway away from allergy development.

[fysai]

tnx po doc.. about his rashes, ang sis ko po kasi ang nag pa check up sa baby ko that time, she said that there was no clear explaination from my baby's pedia on why he has given antibiotics for my baby.. pero tumalab naman po doc that time..
alarming.. kinabahan naman po ako doc, aside from allergies ano pa po kaya ang possible effects on my baby? pls advice me doc on what we should do correctly for my baby..
then clarification lang po doc, about rifampicin and isoniazid.. there are times po kasi that when my baby wakes up, he drinks his milk.. paminsan-minsan lang naman po doc.. pero what we're doing is, 30mins after he drink his milk namin siya pinapainom nang meds, then 30mins after food naman.. tama po ba doc?
then about his intake of pyrazinamide, 30mins after dinner namin siya pinapainom, then becase bedtime na niya 30mins after med naman siya umiinom nang milk niya.. tama po ba doc?
ok lang po ba painumin doc nang oregano extract ang baby ko while under all these medication? maraming salamat po doc..
doc ask po sana ako nang correct dosage of mosegor vita syrup for my baby.. 1yr old, 8.8kg.. thanks a lot doc..

[leletmd]

@fysai:
Frequent antibiotic use may lead to antibiotic resistance, allergic reactions, fungal infections and weakening of the immune system.
Isoniazid and Rifampicin should be given on an empty stomach. If hindi niyo maibigay immediately upon waking up and 30 minutes before breakfast, you should wait 2 hours after niya magfeed bago ibigay ang 2 meds to make sure na empty na ulit ang stomach niya. Pyrazinamide can be given after meals.
Sorry it would be wrong for me to make comments on dosages. It would be best to consult your pedia regarding the proper dosage.
Were you able to find the source of his PC?
Also, since your child has been suffering from frequent infections, I suggest you seek consult with an Infectious disease specialist.

[fysai]

thank you very much po doc.. regarding po sa PC nang baby ko.. maybe he got it from his great grandfather when we visited them at the province, who at that time was newly cured from TB.. that's the time my baby got a cough.. from then on, every month na ang cough niya.. his cousin there was also infected..
one more thing doc, everytime my cough ang baby ko, wala po siyang lagnat.. even now that he is diagnosed with PC, wala pong late afternoon chill/fever, just that cough every now and then.. thank you po doc lelet..
about nga po pala sa oregano extract.. yun kasi ang sabi nang mother ko.. ok lang po ba yon for my baby?
another thing nga po pala doc, about sa PPD niya, umabot nang 20mm ang redness..

[emv555]

hi dra lelet. she was given kidz kit 3 po.maybe i shld tel ask the pedia why no xray recommended. million thanks po.

[leletmd]

@emv555:
I suggest you ask for clarification regarding PC diagnosis since PPD is not enough to diagnose PC. PPD will only show exposure and not disease. If PPD positive, 1 to 2 meds lang ang binibigay.

@fysai:
Aside from the redness, what was the size of the induration (nodule part or hard part at the middle of the PPD test)? We don't measure the redness/erythema kasi. It is the induration that we measure.
I suggest you ask your pedia regarding the oregano extract. Your pedia is the best person to say what meds (herbal and non-herbal) can be given to your baby since she is the one who knows the full history of your baby.

[fysai]

hi doc lelet.. regarding po sa redness, the pedia didn't explained about po sa induration.. he just measured the entire area po na swollen.. but from my observation po doc, sa swollen part was kinda hard and parang pong my mga fine rashes..
ay doc, i've read po your reply for emv555, na pag nag positive po sa PPD, 1 or 2 meds lang binibigay.. why is my baby given 3 meds po? his pedia didn't explained it to us.. bakit po kaya 3meds doc.. thanks po ulit..

[leletmd]

@fysai:
From your first post you mentioned that your baby underwent a PPD test last September. At the same time, a chest x-ray was done. What exactly were the chest x-ray findings aside from the Pneumonia that you mentioned? It is possible kasi for Pneumonia to be caused by the TB organism (TB pneumonia). I am guessing that your pedia treated it as a positive sign for PC.
The best person, though,  to answer your question as to why your baby is being given 3 meds is still your pedia since he was the one who gave the diagnosis of PC.
Try to backread. I posted the criteria needed to diagnose PC/TB on the earlier pages of this thread.

[fysai]

hi doc! the xray result was right basal pneumonia.. he requested for it because sa 20mm na swelling po..
thank you po doc..  more power! 
doc my baby has underwent 2 flu vaccines last july 8 (1st dose) and august 8 (2nd dose).. is it ok po ba doc to have a 3rd dose of it now that he's under medication for PC? or ok na po ang 2 doses ng flu vaccine sa kanya?

[leletmd]

@fysai:
It is possible that your pedia assessed the chest x-ray findings as a positive result for PC. Better to ask na lang your pedia for clarification.

[emv555]

thank u po dra lelet for the advises. so kind of u God bless u

[killbill]

Doc question lang po, nag pa skin test yung daughter ko last monday, then wednesday binasa ng pedia niya yung result, negative naman daw pero pagdating ng thursday-friday, parang lumaki yung spot, negative pa rin ba yun or positive na tapos delayed reaction lang yung sa kanya? tomorrow ko pa kasi siya ibabalik sa pedia niya. thanks in advance

[leletmd]

@killbill:
Pasok pa ba sa 48 to 72 hours? That is the time kasi where PPD reading should be made. After that, whatever reaction that may occur will be insignificant.
Best to ask clarification from your pedia pa rin since she was the one who made the initial reading.