Primary Complex Thread 2

[puglover]

What will happen ba pag overdosage ng zcure?

[midphantom]

Dra lelet,thank you po talaga.. You are a big help.. Binigyaan po ng carboceistin kc may ubo pa rin.. Ang tagal na ng ubo.. 5days po iinumin,tpos na 5 days pero may ubo pa rin..So doctora ok [textspeak!] walang isoniazid, kc mag 2 years old p [textspeak!] naman si baby.. Thank you po

[midphantom]

Dra lelet may pm po ako sa inyo.. Thank you po ulit..

[myjoy]

@dra lelet, thank you posa reply. nung huling monthly check up po ni baby, wala naman pong masyadong sinabi yung doctor. basta ang akala nya, 2 months pa lang daw nagte take ng pyrazinamide si baby. kaya nagulat ako na sumobra ng isang buwan yung pag inom. hindi naman na nya tiningnan si baby...kahit physical exam, wala din po. basta pumunta lang kami dun tapos niresetahan na si baby ng bagong kit..HR kit na po sya ngayon...for the next 3 months.

tsaka doc, ok lang po ba na naggamot si baby agad kahit hindi sya nag ppd? kasi may nakausap po ako na hindi lang daw basta sa xray nagba base yun kasi dapat may iba pa daw tests. mahirap daw kasi sa liver daw po ang complication ng iso at rifampicin. lalo naman ako nafu frustrate sa doctor ni baby. tinry ko sya ilipat pero sabi kasi nung isang pedia, mas magandang matapos yung case kung sino yung doctor na unang tumingin. kasi hindi daw nya malalaman yung comparison before naggamot si baby at yung after.

thank you po ulet doc sa lahat ng tulong nyo!

[rhylie10]

dra lelet ask po ulit.. sensya na po, bakit po di pwedeng ideworm ang batang may pc? thanks

[leletmd]

@Tobeyrich:
Best to ask your pedia regarding the length of treatment with Propan syrup since she is the one who prescribed it.

@rhylie10:
Pasensya na, but if you are giving pediasure in place of a meal, then you are defeating the purpose of increasing his appetite for solid food. Milk should not be used as a replacement for mealtime because instead na magka-appetite siya for solid food, nabubusog siya sa milk. Ang dapat ayusin sa kanya is ang pagkain ng solid food. In most cases, pag binawasan mo ang milk intake, lumalakas ang solid food intake.
Also, hindi absolutely bawal ang pagkaroon ng PC or TB sa deworming kaya lang there are some pedias who do not do deworming kapag may ubo or sipon since some worms may travel through the heart lung route and may make the cough symptoms worse. Best to follow your pedia's advice regarding this since she is the one who knows your child's history.

@yang:
May regular pedia ba ang mga bata? If yes, best to have them both brought for follow up so that they can be re-assessed. Also, dapat sana nahanap ang source of infection.

@puglover:
Overdosage from pyrazinamide may result in liver impairment or increase in uric acid levels. As I mentioned in my previous answer to your question, it is best not to speculate. It would be better to ask your pedias directly as to why there is a need to extend the giving of pyrazinamide since they might have a valid reason for extending it.

@midphantom:
Best to have a follow up with their pedia if the cough didn't go away with the initial treatment.

@myjoy:
Back read ka so that you can read up on the criteria to diagnose TB. PPD test just determines presence of exposure to TB. A negative PPD test doesn't mean that there is no existing PC or TB since there are a lot of false negative cases, especially if the child is very thin or malnourished (immune response kasi is blunted in a child who is malnourished).
We do not do PPD testing all the time. It depends on the presenting symptoms of the patient, presence of probable source, etc.

[rhylie10]

thanks po dra lelet.. about her appetite, will do that dra..babawasan ko po milk intake niya, about deworming po, so pwede parin po siya ideworm while on anti tb meds? kala ko po kaya bawal ideworm kasi baka magka conflict sa anti tb meds na tinitake niya.. wala naman po siyang ubo't sipon ngayon, kung ayaw po ng pedia niya ideworm siya, so next year pa po siya madedeworm;(..

[chrisann]

I need to be enlightened. My almost 10-month-old daughter had swollen lymph nodes at the back of her neck 3 weeks ago. after a week, we brought her to her pedia and she was prescribed to take antibiotics (Cephorex) 3x a day for 7 days. On her 5th day, her swollen lymph nodes reduced in size but not significantly. We were then advised to have her chest x-ray taken and CBC test, which we did. Her x-ray results showed haziness in the right lung. Her pedia also did a PPD skin test on her which turned out negative naman. All throughout, my daughter did not show any signs that she has primary complex. She has good appetite, very active, no coughs and colds. Her swollen lymph nodes as of today is now gone. Despite these, her pedia prescribed her to take an anti-TB medicine which she will take at least 3 months. My question now: Is it necessary for her to take a medicine at this point?

[leletmd]

@rhylie10:
You can switch brands as long as the formulation is the same. For example, for Isoniazid, if current brand used is 200 mg/5 ml, then you have to switch to a brand that is also 200mg/5 ml.

@chrisann:
What was the anti-TB medication that has to be given for 3 months?
Did you ask your pedia regarding why your daughter needs to take the meds?
For kids, the most common symptom of PC is swollen lymph nodes that doesn't go away with antibiotics or other treatment, with or without weight loss, loss of appetite, recurrent cough or colds, etc.
I suggest you clarify first with your pedia the reason for the medications. If unsure as to whether to follow it or not, then you may seek consult with a pedia pulmo or a pedia infectious disease specialist.

[rhylie10]

ahh ok po, thanks, will check the kids kit na bngay po sakin if same formulation, thanks po..god bless

[rhylie10]

good am po dra lelet. had her follow up check up yesterday, dun po sa pedia pulmo, nung last month po is 12.4 [textspeak!] weight niya, last month lang po siya nag start ng gamut, then kahapon po yung timbang po niya is 13.2, kapag nadagdagan po ba ang timbang madadagdagan din ang dosage ng gamut niya? kala ko po kasi pag may improvement babawasan yung dosage, kasi po last month 3.5 ml po yung sa hrz pedia kit, kahapon po sabi ng pedia pulmo gawin na daw pong 4 ml.. ganun po ba yun pag may improvement sa weight madadagdagan po talaga dosage ng gamot? niresetahan din po siya nag pangdeworm, kagabi ko po siya pinainom before bedtime, pag di po siya nagpopoo today bukas po pwede pang lumabas yung worm?TIA po,, godbless,,

[rhylie10]

good am po dra lelet. had her follow up check up last wednesday, dun po sa pedia pulmo, nung last month po is 12.4 weight niya, last month lang po siya nag start ng gamot, then last wednesday po yung timbang po niya is 13.2, kapag nadagdagan po ba ang timbang madadagdagan din po ang dosage ng gamot niya? kala ko po kasi pag may improvement babawasan yung dosage, kasi po last month 3.5 ml po yung sa hrz pedia kit, then last wednesday po sabi ng pedia pulmo gawin na daw pong 4 ml.. ganun po ba yun pag may improvement sa weight madadagdagan po talaga dosage ng gamot? niresetahan din po siya nag pangdeworm, wala po kaming nakita na mga worms/worm;(

[prettybarbie]

Mga sis posible ba na magkaron ng primary complex kapag positive sa skin test pero negative sa xray? Nag positive kasi yung 4 yr old daughter ko sa skin test pero okay naman daw yung xray. Niresetahan sya ng pedia nya ng 3 meds na iinomin for 6 months. After 3 days nya inumin yung mga gamot nagka high fever sya for 2 days then pinatingnan ko sya sa ibang doctor pinapatigil yung anti tb drugs then may mga gusto pa silang gawin na test kasi hindi daw accurate ang skin test (?). Hay nako nako-confuse na ko. Iniinsist nung first pedia nya na ituloy ko yung gamot while yung isang doctor naman nya (we're now in Hong kong...) sinasabi samin na itigil yung gamot. Hindi ko na alam ang susundin ko.

[leletmd]

@rhylie10:
Dosages are computed based on weight so since tumaas ang weight niya, then tataas ang dosage. Hindi binababa ang dosage ng PC meds unless there is a decrease in weight or there is evidence of liver toxicity.
Also, some worms are not visible by the naked eye so possible pa rin na may worms siya kahit na walang nakita. My suggestion is to do routine deworming every 6 to 12 months.

@prettybarbie:
What was the reason for the work up for TB? What were your daughter's symptoms?
Positive PPD with negative chest xray just qualifies for exposure and not for actual disease so dapat sana 1 to 2 TB meds lang ang ibigay for at least 3 to 9 months. Did your pedia explain as to why she opted to treat your daughter as having PC even with negative chest xray? Baka kasi may valid reason sya for treating your daughter.
What other labs gustong ipagawa?

[rhylie10]

thanks po for the reply dra lelet.. godbless

[lent0t]

hello dra leletmd.... i do have some concerns about my son's xray...
we went to the doctor because it's been 1month di pa rin nawawala ang ubo nya. we gave him bisolvon and no effect. he has allergy history by the way. so ayun na nga we went to a pedia-allergologist. his pedia prescribed him medicines that are related to allergies though he had him xray just to isolate yung primary complex. we have now the result of xray and the impression is: non-specific hilar lymphadenopathy. the pedia read it and told us that my son is positive for PC but since he has strong allergies and the symptoms is not that concrete he was recommended for skin test. he had his skin test yesterday but it seems that it is negative. di umuumbok yun area eh flat lang sya. so now im confuse postive xray and negative skin test. magana kumain, malusog, and maliksi. we'll be back tom to check the skin test.... sabi nya kasi if the skin test is negative she will not pursue with the PC medication. my worry naman dun how about the xray? he is positive, pero no medication... baka lumala. by the way, with the allergy meds... nag improve sya. may cough pa rin pero madalang na.

please enlighten me. thank you so much

[chooga chooga]

Hi doc, chest xray of my baby has two results. Yung isa pneumonia. Nagpasecond opinion kami, primary complex. Can we do chest xray again kasi that was last month pa nung nilagnat siya. Also safe po ba na magpa ppd skin test ang pregnant. Kasi im pregnant 9 wks po. Saka doc, if ever ako ang positive sa tb, safe ba ako maggamot ng pang tb kahit pregnant ako at 9 weeks. Thanks doc.

[prettybarbie]

is it okay to repeat an xray after a month? 4 years old lang yung daughter ko... i read somewhere na masama daw yung palaging ine-xray due to radiation... pinapaulit kasi yung xray nya eh...

[leletmd]

@prettybarbie:
Xrays have very little radiation so pwede siyang ulitin kahit after 2 to 4 weeks pa lang.

@chooga chooga:
What was the official reading of the radiologist who read the chest xray?
Pwedeng ipaulit ang chest xray after 2 to 4 weeks if doubtful ang initial results.
Ok lang magpa-ppd test even while pregnant. The test will not harm your baby. If ever you are found to be positive with TB, it is very important that you get yourself treated. There are meds na pwedeng ibigay kahit pregnant ka. Your doctor should be able to guide you through that. If hindi ka natreat, there is a high chance that you will pass on the infection to your unborn child.

@lent0t:
Actually, non-specific hilar lymphadenopathy means that there is enlargement of lymph nodes that may be due to any infection, not necessarily PC. Clinical correlation is needed to determine if it is indeed PC.
Response to the allergy meds is a good sign that his symptoms may be due to an allergic cause.   

[prettybarbie]

^ thanks po sa reply.... may nabasa kasi ko somewhere na frequent xrays in kids increase the chance of getting leukemia...  bigla naman ako naparanoid don.