Primary Complex Thread 3

[hun_nie08]

it says positive on primary PTB, the skin test is positive too. My husband just had xray last May ako naman yesterday so si yaya nalang ang di pa. So nagstart na sya mag med nung Monday. Tanong ko lang po if before bfast yung isang med nya, pano kung dumede sya around 5am tapos bigyan sya ng 6-6:30am ng Rifampicin?

[leletmd]

^ It's suppose to be given at least 30 minutes to 1 hour before breakfast because that's the time the tummy is most empty. One other option is giving the meds 2 hours after food intake. So if she drank milk at 5 am, then dapat 7 am pa pwede ibigay yung meds niya. Ok lang water before but not milk or juice or food or else it will affect the absorption of the medications.

[tintin19]

Hi dra. lelet! I have questions po...

My father is recently diagnosed with minimal PTB based on xray, waiting pa po sa result ng sputum. My mother has history of TB and pneumonia - and recently umuubo po ulit sya. My 2-month old baby, my partner and I visit them regularly on weekends. Gaano po kalaki ang chance na mahawa ang baby ko? Can we continue with the regular weekend visits or should we stay away while they're on medication?

Maraming salamat po.

[leletmd]

^ If it is minimal PTB, as long as your father takes regular medication for 2 weeks, he will no longer be contagious. It will be safer for you to visit after that.
However, prior to his diagnosis, how frequent were your visits or interaction with them? If you were visiting regularly, I suggest that you and your partner have chest xrays and PPD tests done to make sure that you weren't infected or exposed prior to your father's diagnosis.
Did your daughter get her BCG vaccination at birth? How long did it take for the BCG scar to form? If it formed within 1 week from injection, that's what we call an accelerated response and that means she was exposed to PTB while in the womb.

[tintin19]

thanks doc @leletmd!

We visit my parents and stay there overnight almost every weekend since I gave birth last July. Prior to giving birth, I lived with them during my entire pregnancy. Years na po na inuubo father ko, we thought yung ubo nya ay dahil lang sa yosi nya dahil malakas sya mag-yosi. Recently lang nya napagdesisyunang magpa-checkup for my baby's sake. Possible po bang nahawa na ako even without showing symptoms?

Yes doc my baby had her BCG vaccine at birth. It took weeks before I noticed swelling on the site of injection (mistook it for ipis bite), pero hindi ko din po talaga kasi nabantayan yung progress ng BCG scar nya.

maraming salamat po ulit!

[leletmd]

^ Given your mom's history and your dad's chronic cough as well as the fact that you were with them during your pregnancy, I think it would be best if you had a PPD skin test and a chest xray done. It takes several months to years of exposure for TB to develop and for symptoms to appear. Merong walang symptoms pero may findings pala sa chest xray or may mga lymph nodes pala na enlarged. Definitely kasi you were exposed since matagal kayong magkasama. Pero as to if infected ka, it depends on how well your immune system handled the exposure. Usually mas mabilis mahawa ang bagsak ang immune system.

[tintin19]

^- thanks doc lelet! I'll follow your advice at magpapa-ppd skin test and xray po ako one of these days.

[eman306]

Hinde ko alam kung dito ba dapat etong tanong ko, umaasa lang na baka may makasagot sana.

Sept. 27 napansin ko umuubo at may sipon ang baby ko, kaya kinabukasan dinala ko sa dr. ang sabi wala cough lang binigyan ng gamot kaso ang baby ko lagi isinusuka ang gamot kaya sept. 30 dinala ko ulit sa dr tapos may wheezing daw at diagnose ng broncholitis, so pinagnebulize ng 1.5ml na ventolin at 2.5ml na saline (3x a day for 3 days at 2x a day for 2 days) tapos 9 drops of fenistil morning and evening for 4 days. Then sabi baka 5 days ang ubo ni baby

Ngayon tapos na ang course ng gamot at nebuizer ni baby kaso may ubo pa din na every now and then may kasabay pa din na sneeze. parang may plema yung ubo ni baby.

Tanong ko lang ganun ba talaga? di ba agad agad matatanggal ang ubo? should i jst let it run its course or dalhin ko ulit sa pedia?

7 months pala si baby

salamat

[abyquitz]

Hi @leletmd,

ask ko lang po ok lang po ba na ituloy ang schedule vaccination ng baby habang on going ang treatment ng PC?

schedule vaccination po ng baby ko ay: MMR, Chicken pox vaccine, and HEP A

thank you po.

[jell-00]

good day! dra ask ko lang nung nag pa-chek up po kame may cough and cold po anak ko nung september mga 3rd week po. nag reseta po [textspeak!] pedia ng cefixime,cetirizine,salbutamol via nebulizer for 3 days. the na tapos na [textspeak!] antibiotic niya hinde padin nawala yung ubo niya then dinala namin sa ibang pedia binigyan naman siya ng azithromycin cetirizine and salbutamol syrup. natapos na din po treatment may ubo pa din po pero hinde na ganun ka lage pero present padin po siya pati [textspeak!] sipon po pa minsan minsan meron pa din po, advice ni pedia na ibalik pag hinde padin gumaling and request for chest xray. do you think dra positive kaya siya na PC? hinde pa din namin dinadala kasi natatakot ako baka nga mag positive siya. naawa lang ako.

[leletmd]

@eman306:
If there is still cough and colds, then it would be better to bring your baby back to the pedia for a re-assessment. There are times na matagal mawala ang symptoms ng bronchiolitis kaya better na namomonitor ng pedia.

@abyquitz:
You can have your baby vaccinated while receiving treatment for PC.
Ang hindi pwede ay magpa PPD test if less than a month pa lang kabibigay ng Measles or MMR vaccine. Measles and MMR vaccine has been shown to cause false negative results kasi kaya dapat maghintay ng 1 month bago magpaPPD test kung kabibigay pa lang ng Measles or MMR vaccine.

@jell-00:
How old is your child? Is there anyone else at home with the same symptoms? Wala ba siyang allergies? Allergic rhinitis or asthma? What were the physical examination findings?
Since symptoms have yet to resolve fully, I suggest you bring her back to the pedia for a re-assessment.
Ang chronic cough or cough for more than 3 weeks ay hindi necessarily PC. Pwede rin allergies, pwede rin reflux, pwede residual cough from another infection na hindi PC like bronchiolitis or even influenza or trangkaso. Better pa rin matingnan siya ng mabuti para tamang gamot ang maibigay sa kanya.

[jell-00]

seven months old na po baby ko. apat lang naman kame sa bahay and i dont think na may TB isa samin, yung unang check up namin sa isang pedia may asthma daw po si baby. yes dra this week ibalik namin siya sa pedia niya, minsan nag sumpong ng cough niya pag tulog siya middle of the night. thank you dra! 

[leletmd]

^ Maternal antibodies start to wane at 6 months of age kaya mas madaling dapuan ng sakit ang baby at that time. Mas mahina resistensya nila kaya dapat yung mga primary immunization doses ay naibigay na at 6 months.
Marami ring viral infections na tunog hika at that age katulad ng bronchiolitis kaya hindi pa usually nagdiadiagnose ng asthma. Anyway, best to follow up na lang to monitor your child's progress.

[abyquitz]

Hi dra leletmd
thank you po sa response nio..
Magpapa-appointment na po kami para sa vaccinations ni baby.

[Sjc08]

@leletmd good noon doc, yung baby ko nadiagnosed ng PC and his pedia prescribed kidz kit 3 for 6 mos,pyrazinamide for 2 mos..2 weeks ata after nagstart kami ng medication lumabas ubg pantal pantal nya sa katawan...halos everyday po un, mag 2 weeks na on and off rashes nya. Pinapaisa isa ang bigay ng meds para malaman ano ang cause...
First 3 days is pyrazinamide muna
2nd 3 days is rifampicin
Then last is isoniazid then resume ulit

1st 3 days of pyra , may pantal pa din sya
Now mag start na po kami give ng rifampicin. Stop po for 3 dyas [textspeak!] pyra while giving rifampicin alone tama po ba?to test if mangangati sya sa rifampicin?
Thanks in advance

[leletmd]

@Sjc08:
Nagtreat ba muna for the pantal before doing rechallenge? Hindi totally nawala ang pantal bago binalik ang mga meds? Was it just your pedia who advised you to do rechallenge or narefer na kayo sa allergist?
If hindi pa kayo natingnan ng allergist then I suggest you go to an allergist near your area so that you can be properly guided on how to do rechallenge.

[Sjc08]

@leletmd

Doc nagpunta na kami sa allergist, un ang pinagawa, kilala nyo po ata si dra. Tayag. Sakanya po kami pumunta...un po ang reseta nya. First 3 days is pyrazinamide muna then next 3 days rifampicin then last yung isoniazid. Then observe kung may mga lalabas pa ding mga pantal then kung sobrang dami painumin ng cetirizine. Tama po ba [textspeak!] pagkaintindi ko?yung samention ko sa first comment ko?

[leletmd]

@Sjc08:
Pasensya na but I cannot post how to do proper rechallenge here in the forum. This procedure is best discussed in the clinic. Since you were able to bring your child to Dr. Tayag already, I suggest that you clarify it with her so you can be guided accordingly.

[dropdeaad]

Hi doc ask ko lang kasi 3 months na kami naggagamot sa anak ko ng PC kaso napapnsin ko ang dami niya pa din kulani sa batok saka parang ewan ko kung tama pagpapainom ko ng gamot 2 hours after niyang maglunch doon ko siya paiinumin kasi pag morning naghahnap agad siya ng dede tapos after uminom 30 minutes kakain na siya kasi ayun ang advice ng pedia niya ibalik ko nalang kaya sa umaga ulit ang pagpapainom sa kanya? Saka nagwoworry ako sa kulani eh

[leletmd]

@dropdeaad:
Hindi lahat ng kulani ay related sa PC. Usually neck or clavicular (sa may base ng neck and shoulders) as well as in the lungs ang lymph nodes na lumalaki with PC.
Wala ba siyang ear or scalp infection? Recurrent colds?
Ano ang initial findings prior to diagnosis of PC? If hindi talaga kaya ang empty stomach early in the morning, pwede nga rin ang 2 hours after food intake.