Primary Complex Thread 2

[jenybasti]

Since nadiagnosed yung niece ko na may tb last month, inadvise ng pedia na mag ppd saka chest xray si baby.di rin kasi sya nag gain ng weight for the past few months.
Negative naman yung xray nya.yung skin test positive 15mm yata yung result kung hindi ako nagkakamali.isoniazid lang ang nireseta sa kanya 2ml for 9months.

[doopz]

hi doc lelet, yung anak ko po (6y/o) kasi meron syang kulani/bukol sa kilikili. last november 2012 pinacheck up ko sya sa pedia. worried kasi ako dun sa kulani nya sa kilikili medyo malaki kasi para syang jolen. sabi ni pedia normal naman daw talaga yung mga kulani. since may ubo't sipon din yung anak ko that time, niresetahan nya yung anak ko ng antibiotic tapos pina-chest x-ray at para [textspeak!] daw ako mag-alala ni-refer nya ako sa surgeon. yun dinala ko yung anak ko sa surgeon. same din cla normal ang mga kulani lalu na kapag may cough and colds. sabi nya hintayin ko daw muna matapos yung antibiotic at ipa-ppd test ko daw yung anak ko. if magnegative daw sa test babalik daw ako sa knya para i-remove at icheck kung ano ba yung kulani/bukol sa kilikili ng anak ko. bumalik kami sa pedia for ppd test. yung result ng chest xray is bronchial cuffing was noted at the perihilar region. heart and other structures are normal. conclusion: bronchitis tapos nagpositive sya sa ppd. pinagtake nya ng kidz kit 3 yung anak ko. december 2012 kmi nagstart. now naka- kidz kit 2 na sya.

since nagtake po sya ng kidz kit medyo lumiit yung kulani sa kilikili nya compare dun sa dati na kasing laki ng jolen. mas malakas sya ngayon kumain. kaya lang parang hindi sya tumataba at  bakit ganon po katatapos lang nya mag-antibiotic nung 2nd week ng feb. nawala naman yung ubo nya tapos ngayon [textspeak!] na naman inuubo na naman sya ulit. prone po ba talaga sila sa ubo't sipon? nakakaawa naman po kasi puro gamot na lang lagi. tia!

[leletmd]

@jenybasti:
Positive PPD means there is definite exposure to TB and since your niece has also been found to have TB, that means there is an active source of TB in your household. I suggest that you have everyone in your household at least get a chest x-ray kahit na walang symptoms to find out kung sino nakahawa sa niece mo and naka-expose sa child mo and para magamot din ang source of infection.

@doopz:
Children taking PC meds can still have cough and colds kasi there are a lot of other causes of cough and colds such as viral, bacterial  infections and non infectious causes such as Allergy and reflux.
Nahanap na ba ang source ng TB sa household niyo? If hindi pa, then I suggest that you have all the adults undergo at least a chest x-ray to determine kung sino ang naka-infect sa kid mo and have that person undergo treatment as well. Finding the source and treating the source lessens the chances na bumalik ang TB ng anak mo.

[babybubot]

good pm doc leletmd, ask ko lang po may son have allergic rhinitis yung sipon nya mawawala tapos babalik laging ganon. Last sunday napansin ko may kulani sya sa leeg parang kasing laki ng jolen. Parang bigla na lang sumulpot. Madalas kasi pag inuubo sya at sinisipon check ko agad yung leeg baka nga may kulani wala naman ako nakakapa. Nag xray sya saka PPD test nung monday. Negative sya sa PPD test ang impression sa xray nya is pneumonitis. Pero sabi ng pedia may plema pa sya saka may kulani din sa lungs. Hindi sya niresetahan ng gamot ang anak ko maliban sa vitamins and montemax tab para allergy nya. Tinanong ko dn kung possible mag develop sa PC yun ang sabi nya YES kaya palalakasin daw ang lungs ni baby. Posible bang may PC din sya? Medyo worry ako kasi malapit na kami magprocess ng papers for abroad baka bumagsak sya sa medical. Gusto ko sana as early as now mag gamot na sya para kung sakali okay na lahat. Thanks po!

[leletmd]

@babybubot:
Pneumonitis refers to a viral infection causing inflammation in the lung area. Since there is an infection, the lymph nodes will really enlarge to produce antibodies. It will resolve on its' own with just supportive treatment.
Pneumonitis is very different from PC or TB.
My suggestion is that you try to control your son's AR. Perhaps, montelukast is not enough treatment for him. I suggest you visit an allergologist before you leave the country para ma-guide na rin kayo sa transition.

[babybubot]

^thanks for the reply doc, what a relief kahit pano di matagal na gamutan ang pagdadaanan namin. Balak ko talaga ipacheck sa allergologist kasi meron din sya kasi rashes sa batok bigla na lang din dumami nung nakamot nya. Salamat doc leletmd.

[duan]

hi. doc lelet, may question po ako. i dont know kung natanong na din po nung iba since bago lang po ako dito. yung pamangkin ko po kasi nag positive sa ppd test tpos po normal nman po yung chest xray nya pero advice po nung pedia na magtake pa din po sya ng medicine for PC until 6 months. pina xray ko na din po lahat ng kasma namin, may isa po na ang impression is "granuloma formation". is she the source? kasi po may baby po ako ngayon na 8 months. she is also done with ppd test, negative nman po. advice nung pedia na mag take din sya for 3 months eh kaso ayaw k po sana isubject yung baby ko sa too much medicine kung hindi nman po kailangan. although yung nag karoon po ng granuloma eh hnd na po bumalik samin. inulit din po nung pedia yung bcg vaccine nung baby ko since hindi po nagscar yung bcg nya nung newborn pa lang sya. thank you po in advance.

[puglover]

bawal daw yung taho sa may primary complex? sabi ng MIL ko. sabi daw ng doctor niya before..

[leletmd]

^ As far as I know, hindi bawal ang taho sa patients na may PC. Soy is a good source of protein for energy building in patients undergoing treatment for PC.

[puglover]

Dra, my pedia advised na wag na mag vitamins si baby. Masyado na daw kasi madami iniinom. Kaso sinipon/ubo nanaman. Helpful kaya kung amg add ako nung usual multivitamins niya or vitamin c man lang? Immune booster nga sana gusto ko, echinacea? Parang ang hina kasi ng resistensya niya..

[BAISANAN]

hi dr. my son is 6 yrs. old he's into medicine of primary complex pansin ko lang parang wala
parang wala naman nagbabago sa kiddo ko. hindi nag gain ang weight sya and still mahina
kumain. any opinion? thanks.

[leletmd]

@puglover:
Pasensya na, but I would trust your pedia's judgement regarding need or no need for multivitamins. She is the one who is most knowledgeable about your baby's health condition kasi.

@BAISANAN:
How long has he been taking the meds? Have you found the source of infection and has the source started treatment, too?

[eurickha]

Hi Doc Lelet

my youngest daughter already completed the 6 months medication and, my pedia said for a repeat xray to compare to the previous ones. my daugther is 3yrs and 5months she only gained 13.7kls from her previous 11kls maganda ang response niya sa meds and hindi na siya masyado sakitin ngayun mas nalalabanan niya yung sipon at ubo . The xray results finding:

Follow up films as compared to radiograph dated 9-24-12 show further clearing in the bilateral PTB densities and HIlar lymphadenopathies.
Heart remain enlarge
Diaphragm and bony thorax are unremarkable

Kaya her pedia told us for 3 months extension and adjust her dosage intake to 5ml of kids kit 2 but still wer'e happy coz it improves better on her appetite and sobrang kulit. Hopefully matapos na niya and gumaling na tuluyan ang Koch infection niya . Thanks a lot Doc Lelet for this thread naisheshare ko ang thoughts ko More power Doc


 

[puglover]

thanks, doc!

[artemis26]

when my kid was confined at PCMC due to amoebiasis, we requested for an xray upon checkout. Tapos ang naging findings: pneumonitis, right lungs. meron rin nakalagay na "streaky infilitrates on the right lung" kaya ganun ang imprression. We had her checked by Dr. Leandro Cabanilla (also at PCMC), and he compared it with a previous xray done a year ago (in which the finding was negative), tapos sabi nya, negligible naman raw yung pneumonitis, ie, di naman raw dapat iworry kasi very,very minimal lang raw ang difference between the 2 xrays. tapos that time we had her checked by Dr. Cabanilla, wala naman daw syang ubo/sipon, very clear lungs. Upon reading here now, I confirmed na siguro that time na inflammed ang lungs nya ay due to infection nga..prior kasi to confinement, she had an on/off bout with sipon. Salamat talaga kay sis eletmd, at least naipapaliwanag yung mga stuff na medyo nawawala sa isip ng mga parents during checkups

[puglover]

dra, what if you miss a dose or two? ulit ba talaga sa umpisa?
or kung ma-double dose kasi nagkamali? what to do?
2 meds in the morning 1 before sleeping kasi yung sa baby ko, nadoble painom nung sa umaga, napainom din sa gabi
tia

[puglover]

and dra, clarify ko lang din, totoo ba na pag nakakainom na ng meds hindi na mahahawa sa coughs and colds sa iba?

yung helper namin ganun daw kasi yung daughter niya, umpisa nagtake ng meds hindi na daw inubo or sinipon.

[leletmd]

@puglover:
Doubling the dose increases the chance of liver toxicity. Missing a dose increases the chance for resistance and allergies. I suggest you post a schedule of your child's meds on the ref or on the medicine cabinet so that errors like this will be avoided. Assign only 1 person to give the meds.
Even while undergoing treatment for TB, a patient can still have cough or colds because there are lots of other causes of cough or colds such as other infections, allergies, etc.

@xadie28:
My guess is that the enlarged lymph nodes in the hilar region prompted your pedia to suspect PC. Sa hilar region kasi madalas nagtatago ang TB organism. I suggest you clarify with your pedia also since there may be other reasons why she suspects PC or TB.

[ankyneMD]

good pm po dra.lelet. Newbie po ako. And its my first post here in GT. diagnose din po ang anak ko ng primary complex. Three m0nths na siya ng medication for pc, tanong ko lang kung bakit pawisin pa din siya hanggang ngayon? Kelan po ba mawawala yung symptoms ng pc? 25kg po ang weight at turning 5years old siya this march 28. At ok lang po siya painumin ko ulit ng green barley? Did you know about that?

[leletmd]

@ankyneMD:
Sorry I am not really familiar with green barley. Please ask your pedia regarding this kasi she is the best person to ask regarding what meds or supplements to give to your baby since siya ang nakakaalam ng history ng anak mo.
What were his initial symptoms and findings that formed the basis for the diagnosis of PC?
Night sweats ba ang hindi naalis sa kanya or general na pawisin? If general na pawisin, it is possible na this is not at all related to PC and it can be just due to his fast metabolism. Response to PC meds varies depending on the immune response of the patient. Are you able to bring your child back for his monthly follow up with his pedia? This is important to assess his response to the meds.
If we base it on weight for age, above average ang weight ng anak mo for a 5 year old. Ask your pedia for his ideal weight for height kasi better to correlate the weight with the height compared to age.