Primary Complex Thread 2

[leletmd]

@teejiko:
Yes, if old pedia cannot be located anymore, you can bring her to a new pedia for evaluation. I suggest though, that you be honest with your new pedia regarding the incomplete treatment. As doctors kasi, we are dependent on the information that our patients give us so kung mali or incomplete information, then baka maging mali ang management or treatment.

@1choi_ko9:
Aside from the househelp, lahat ba ng adults sa house (relatives included) nagpa - chest x-ray?
Transmission is through respiratory droplets: being exposed to phlegm by coughing or sneezing of an adult patient with TB. Hindi siya natratransmit through kissing lang sa cheeks. Usually matagalan na exposure bago mahawa kaya we always say, before we look for sources outside the home, dapat na-exhaust muna all means to look for a source inside the home.
Improvement of symptoms usually happen within the 1st 2 months of treatment. Does he have monthly check ups? How is his weight in relation to his lack of appetite? What did your pedia say regarding the lack of appetite? Wala bang ibang possible cause for that? Picky eater ba siya or talagang walang appetite? How is his milk intake in relation to his solid food intake? 

[teejiko]

^Thank you so much doc leletmd!! Appreciate the help and suggestion. Will do that... thanks again

[strauss]

Hello doc leletmd, chest xray lang po ba ang kailangan para madiagnose na may TB ang isang  adult? And once treated hindi na ba nila mahahawaan ang baby?
Uuwi po kasi kami sa Pinas, my baby is 10 mos.
my pamangkin had PC pero tapos na po yung 6 mos treatment nya nung May and sabi ng sis ko magaling na daw sya. Hindi nila alam kung kanino nahawa yung bata, kung sa side ba namin or sa inlaws nya. Kaya bago kami umuwi eh gusto ko muna masiguro na hindi sa mga adults sa house namin ang may TB.

Thanks.

[leletmd]

^ Same with kids, dapat mafulfill 3 out of the 5 criteria for diagnosing TB sa adults:

Review natin ulit ang criteria:
a. History of exposure to a person with TB
b. Positive PPD
c. Chest x-ray findings consistent with TB
d. Signs and symptoms suggestive of TB
e. Positive sputum AFB - this is the gold standard for the diagnosis of TB in adults

I agree that you have to find the source of your niece's PC prior to going here. Dapat kung sino ang mas madalas na makasama ng bata, yun ang unang ipatest for TB.

[strauss]

Thanks doc leletmd. =)

[gheb]

hi! i assume i can get advice from doc lelet here, i have a son with pc. 2 mos na nag med pero meron pa din sya kulani. yun kc ang nakita namin symptom kaya sya na x-ray and nagpositive sya. pero until now 2 mos na nga meron pa din kulani. sa may likod ng ulo nya lang naman
.

[lizzsie]

hi doc let my son also diagnosed with pc he takes HRZ kit med ask ko lang doc let kung yung urine nya is talagang nag color orange?nakabakasyon pa kc [textspeak!] pedia nya kaya di ko pa natanong..
thanks in advance doc

[leletmd]

@gheb:
What was the size of the lymph nodes before treatment and now? Same pa ba ang size or may decrease na in size?
Hindi kasi mawawala ang kulani. Meron talaga tayong kulani all over our body because these are part of the lymphatic system and they are important sources of antibody production. Kaya siya lumalaki at nakakapa dahil nagproproduce siya ng antibodies in response to infection, wounds, allergies, etc.
What were the chest x-ray findings?
Hindi naman lahat ng malalaking kulani dahil sa PC. It depends on the site of the lymph node enlargement. If PC, usually sa leeg at sa lungs ang may lymph node enlargement.
Wala ba siyang sipon/ear infection/dental caries/seborrheic dermatitis with infection? Those are the usual reasons for post auricular lymphadenopathy or kulani sa likod ng ear/head.

@lizzsie:
Expected reaction ang orange urine/sweat/tears from taking Rifampicin. It is a good sign that the drug is being absorbed well.

[lizzsie]

@lizzsie:
Expected reaction ang orange urine/sweat/tears from taking Rifampicin. It is a good sign that the drug is being absorbed well.
[/quote]

tnx doc let planning to consult other pedia sana habang ala yung pedia so good sign nman pala..thanks again

[gheb]

@gheb:
What was the size of the lymph nodes before treatment and now? Same pa ba ang size or may decrease na in size?
Hindi kasi mawawala ang kulani. Meron talaga tayong kulani all over our body because these are part of the lymphatic system and they are important sources of antibody production. Kaya siya lumalaki at nakakapa dahil nagproproduce siya ng antibodies in response to infection, wounds, allergies, etc.
What were the chest x-ray findings?
Hindi naman lahat ng malalaking kulani dahil sa PC. It depends on the site of the lymph node enlargement. If PC, usually sa leeg at sa lungs ang may lymph node enlargement.
Wala ba siyang sipon/ear infection/dental caries/seborrheic dermatitis with infection? Those are the usual reasons for post auricular lymphadenopathy or kulani sa likod ng ear/head.

^nasa likod ng tenga nya minsan lumiliit sya minsan nman malaki ulit. since nag meds sya now lang ulit siya sinipon. wala naman sya ear infection and problema sa ngipin kc till now ok pa lahat. seborrheic dermatitis with infection wala din naman. pero nung baby pa sya nagkaron sya ng something sa pisngi nya at sa arms, ang sabi ng pedia skin asthma pero wala na nga. yun sa arms nya patse-patse na parang pabilog pero dry sya hindi sya oily or watery. may nireseta na pampahid ang pedia na physiogel yun nawala nga. since then di naman bumalik. last time na nagvisit kami sa pedia di naman nawawala ang kulani agad.
with regards sa result ng xray nya yun pedia na ang kumuha sa hospital tru phone call that time kc need na nya makuha result dahil mag out of the country sya. nagclinic din kc sya dun sa hospital eh.

[gheb]

@doclelet
^nasa likod ng tenga nya minsan lumiliit sya minsan nman malaki ulit. since nag meds sya now lang ulit siya sinipon. wala naman sya ear infection and problema sa ngipin kc till now ok pa lahat. seborrheic dermatitis with infection wala din naman. pero nung baby pa sya nagkaron sya ng something sa pisngi nya at sa arms, ang sabi ng pedia skin asthma pero wala na nga. yun sa arms nya patse-patse na parang pabilog pero dry sya hindi sya oily or watery. may nireseta na pampahid ang pedia na physiogel yun nawala nga. since then di naman bumalik. last time na nagvisit kami sa pedia di naman nawawala ang kulani agad.
with regards sa result ng xray nya yun pedia na ang kumuha sa hospital tru phone call that time kc need na nya makuha result dahil mag out of the country sya. nagclinic din kc sya dun sa hospital eh.
may nabasa ako na reply mo sa isang nag ask, scalp infection? kc my son, palagi sya nagkakamot ng ulo nya pero wala naman sugat or something. parang dry lang ang scalp. is it possible na yun cause ng kulani?

[she29]

hi doc let ask ko lang po kung possible na bumalik ang pc sa bata kasi nag treat na yung daughter ko for 9 mos tapos nagka ubo sya sya tapos ng suggest yung bagong pedia nya na mag xray sya kasi hinde parin sya ng gain ng weight kasi picky eater parin sya.ang impression sa xray was pnuemonitis (something like that)or primary ptb further study suggested yun ang nakalagay sa xray nya .ang gusto ng new pedia mag take sya ng meds for primary so i  consulted pedia-pulmo she said pag nagpa xray daw ng my ubot sipon most likely may findings kasi my ubot sipon sya nung time na nagpa xray sya.nagprescribed sya ng antibiotics and ng improved naman yung condition nya wala na syang ubo.please enlighten me na confused lang ako sa new pedia nya i told her naman na nagtreat na kami before lumipat kasi kami ng house kaya i have to find a new pedia thanks in advance.

[leletmd]

@gheb:
I suggest you get the official results of the chest x-ray from the hospital. You need that for record purposes and for comparison later on.
Scalp infections/allergies can cause enlargement of lymph nodes sa back of the ears.
Meron ba kayong regular follow up with your pedia since the treatment was started? Ano ang sabi ng pedia mo sa hindi pagkawala ng kulani?

@she29:
Primary complex means 1st time to get TB infection so yes, pwedeng umulit ang TB sa bata kung hindi nagamot ng maayos ang bata or na-expose siya ulit sa TB at at time na mahina or bagsak ang immune system niya.
How old is your child now? Nahanap ba ang nakahawa sa kanya ng TB and nagamot ba ang source of her infection? Also, how many months or years ang pagitan from the end of the 9 month treatment to this episode of cough and colds? Before nag-stop ng treatment, nag-gain na ba siya ng weight, nag-improve ang appetite and activity, lumiit ang lymph nodes?
Pneumonitis refers to inflammation of the lungs most commonly caused by viral infections. Magkaiba ang findings ng pneumonitis sa PTB. Can you post what were the findings on the chest x-ray other than the assessment you posted?
I agree with the Pedia pulmo that the chest x-ray findings are most likely due to the current bout of cough and colds that your daughter had during the time the chest x-ray was taken. Since gumaling naman siya with the antibiotics, then most likely it was due to the pneumonitis rather than PC kasi kung dahil sa pagbalik ng TB yun, hindi gagaling basta basta with antibiotics kasi hindi naman yun ang gamot for TB.
 

[bvtolentino]

Hello everyone! am a newbee here, just signed up. Wud like to ask lang po sana if anyboby here cud recommend the best multivitamin & cough medicine for a 5 yr old?  thank you very much!

[drex]

good am doc,just want to ask,does an allergy rhinitis also causes primary complex?.my son was diagnosed primary last july,,and were taking the 3 medicines for almost a month now,until now he still sneezing every morning,maybe 3-5 times in a row..he's eyes got itchy and watery..before his pedia gave him Allerkid for the allergy but that was before he was diagnosed pc.it is okay  if i let him take allerkid again with this 3 medicines for primary?pls. enlighten me.thank you very much...

[france0220325143]

ano po ang mangyayari kapag hindi natutuloy tuloy ang medication? yung pamangkin kasi ng bf ko, since hiwalay parents nya minsan nasa mom. and kapag nandun sya, hindi nila natututukan yung meds ng bata. 2 years na po na [textspeak!] bata, on and off ang pagppapainom ng gamot

[leletmd]

@bvtolentino:
Sorry, but medyo OT yung post since this is the PC thread. Also, I wouldn't suggest self medicating (kahit pa recommended sa forum), especially when kids are concerned. Please go to your pedia for proper evaluation of your child's needs and so that the proper meds can be given.

@drex:
Unrelated na sakit ang primary complex sa allergic rhinitis. Primary complex is an infection brought about by exposure to an individual who carries the mycobacteria while Allergic rhinitis is an allergic disorder that is most likely passed on or namana and brought about by exposure to an allergen. Ok lang itake ang allergy meds together with PC meds.
If symptoms of allergic rhinitis are persistent, I suggest you bring your kid to an Allergologist for proper diagnosis, evaluation and management.

@france0220325143:
If hindi naibigay ng maayos or tuloy tuloy ang PC medications, there is a possibility of resistance to the medications, failure of treatment and possibility of allergies once ma-restart ang meds.

[france0220325143]

thanks doc! and kung magkaroon nga ang bata ng resistance to treatment, or failure of treatment... ano pong magiging effect nun? I mean, complications for example?

[drex]

hi doc lelet,just want to ask again,pacensya na po kung medyo makulit,is there a possibility po ba na magkaron pa rin ng ubo at sipon ang anak ko even if nagte take sya ng 3 meds for pc?so curious [textspeak!] po...thank you very much po.and more power!

[leletmd]

@france0220325143:
Failure of treatment means hindi siya gagaling and pwede mag-spread ang TB bacilli sa other areas of the body like the liver (TB of the liver), bones (Pott's disease) and meninges (TB meningitis).
Resistance to treatment means hindi tatalab yung mga meds na tinitake niya ngayon dahil sa hindi regular na pagbigay sa gamot so if ever, he needs to treat again, tendency is papalitan or dadagdagan ang mga meds nito.
Question lang, hindi ba dinadala for follow up ang bata sa pedia niya while on PC treatment? Dapat kasi namomonitor ang response to treatment ng bata kaya important ang follow up.

@drex:
Yes, pwede pa rin magkaroon ng cough and colds kasi marami pang ibang causes ng cough and colds, other than PC. So kung nagkaviral infection ang bata while on PC meds, pwede magka-cough and colds because of the viral infection. Once gumaling na ang viral infection, mawawala na rin ang cough and colds.
Kung allergy ang cause naman, ang cough and colds pasumpong sumpong lang and is due to exposure to an allergen.