Primary Complex Thread 3

[BabyZ]

Hello. yung baby ko po may ubo't sipon nanaman he's on medication na 3rd day na ng medication nya ngconsult na kami sa pedia, after nung medication sabi ng pedia ipapachest xray daw namin si baby kasi  ang laging reason ng sakit nya ubo't sipon netong last month lang nagkasakit nanaman siya ubo't sipon 1 yr and 3 months na sya.. Ang gamot niya is Amoxicillin and Loraped tapos pinapainom ko din sya ng katas ng malunggay leaves.. Okay lang po ba yun Doc lelet na isabay ko yung malunggay leaves? and wala na lagnat c baby since nung sunday pa malikot sya, ubo't sipon tapos my phlegm sya..  Sana naman hindi sya magkaroon ng primary complex Sabi nung mama ko nung baby ako nagkaroon daw ako ng primary complex e.

[leletmd]

@bvlgari:
The soft or watery stools can be a side effect of the meds. If is happens frequently, I suggest you mention it to the pedia so that proper measures may be instituted.

@BabyZ:
It would be best to ask your pedia regarding the malunggay leaves since he or she is the one who knows the medical history of your son.
Hope he is doing better now.

[bvlgari]

Maraming Salamat po Doc Lelet for accomodating and educating me/us. More power to you! God Bless You!! 

Till next time... 

[loline]

hi doc lelet,

my daughter is on her 5th month of TB meds. recently lang namin nalaman na baka sa lola siya nahawa. yung x-ray kasi ng lola is not clear, so she underwent sputum test.  we are still waiting for the results of the test.  but just in case na positive siya with TB, kailangan ba na totally hindi na namin muna paalaga yung daughter ko sa lola niya while she is on medication?  lola kasi ang nag-aalaga sa kanya. how long does it take para masabi na hindi na contagious yung TB kung nagme-medicate na yung adult?

thank you!

[joevicko]

hi Doc lelet, here is the case naman po of my son:

he is on 6th month, pero po since 3months siya, once a month meron po siyang sipon at ubo pero wala naman po phlegm, pero parang may naririnig po ako halak sa dibdib nya, pero pag pinapacheck up ko siya sa pedia nya, wala naman daw po halak at never siya nag bigay ng gamot sa baby ko, either nasal spray lang palagi at praise God nagaling naman sya after 3 days.. nitong huli po, nagkaubo at sipon uli siya, nung pinacheck up namin kasi meron parang thick saliva na niluwa nung umubo siya (feeling namin phlegm yun) sabi ni pedia nasal drops lang saka inebulize 3x a day ng NSS lang.. at as long as walang fever at worsening cough e nothing to worry about. do you think possible na mag ka primary complex siya or allergic rhinitis lang yun, thanks po

[leletmd]

@loline:
In my opinion, you don't need to isolate your daughter anymore from her lola since she has already been exposed and is undergoing treatment already.
It takes 2 weeks of continuous medication for a patient with TB to be considered non-contagious.

@joevicko:
The symptoms you enumerated are not attributable to allergic rhinitis nor PC.
At 6 months, it is still too early to diagnose him with Allergic rhinitis since infants below 2 years of age really have frequent bouts of viral infections that may manifest as cough and colds because their immune system is still developing.
If clear ang lungs niya and he does throat clearing, then it is possible that his nose is congested causing post nasal drip. I think your pedia is on the right track in handling your son's case.

[joevicko]

ok doc noted po, thank you.. last question po Doc. medyo OTT madedetect po ba thru stethoscope kung may tubig sa lungs ni baby? kasi po nabasa ko dito sa GT forum, yung baby nya sumuka once then may lumabas sa ilong, then after 3 days po nilagnat and ang finding is my pneumonia na yung baby nya.

sa anak ko po kasi, mga 7 out of 10 na nasuka siya is palaging may nalabas sa ilong na gatas, kahit n po karga ko na siya at pinapaburp. every check up naman po ni baby sa pedia nya monthly is wala naman sinasabing problem si pedia. ano po kaya ang cause ng paglabas ng gatas sa ilong ni baby kahit karga ko na sya at nasa burping position. TIA po doc

[leletmd]

^ We are out of topic. Baka mapagalitan ng mods since this is the PC thread pero anyway, yung sumuka na may lumabas sa ilong na nagka-pneumonia, that is called aspiration pneumonia. Iba yan sa tubig sa lungs pero yes, we are able to detect if there is fluid in the lungs with the use of stethoscope. Nadedetect din through steth if there is pneumonia so hindi all the time, kailangan ng chest xray.
With your baby, if it is recurrent na sumusuka after feeding, baka may over-feeding. Please have your pedia assess if feeding is being done correctly.

[ankyneMD]

hi doc lelet. Question ko po ulet. Possible po ba bumalik ang primary complex ng bata or mainfect ulit siya??? My daughter (5years turning 6) 9months ang medication niya. September this year po natapos ang medication niya. Is it possible na mainfect ulit siya or magrelapse ang pc niya? If possible paano ko po malalaman kung may pc ulit siya at gaano katagal? (knock on wood) wag naman sana..
Inuubo po kasi siya ngayon at two weeks na. One week palang yung ubo niya, dinala ko na siya sa pedia niya pero sabi ni pedia wala naman daw phlegm at baka sa panahon lang daw kaya inuubo pero may tonsilitis at niresetahan ng antibiotic at asfrenon gf for cough at loraped for colds. One week niya ininom yan lahat Pero bakit di pa din nawawala cough niya though occasional na lang naman pero pag umuubo siya may naririnig akong phlegm at may dinudura din siya phlegm? Yes medyo marunong po siya magdura ng phlegm. Kaya po natatakot ako na baka bumalik yung pc niya. Nag treat na din yung source so san niya kaya pwedeng makuha ulit ang pc.? Tia doc
Sorry napahaba ang post.

[leletmd]

^ Kids who had Primary complex can get re-infected with TB (PC means 1st time to get the TB infection so yes, pwede umulit), especially if the meds were not given properly or the source was not identified and treated. However, having said that, I do not think that your child will develop re-infection as fast as 3 months after completing treatment. Most likely your child has a different cause for the prolonged cough.
There are a lot of causes of prolonged cough. Hindi lang ito dahil sa TB. Even the common cold or trangkaso can produce symptoms lasting for a month or more. Aside from infections, allergies are also a major cause of prolonged cough and colds. Marami talagang nagkakasakit ngayon because of our weather. My advice is to follow up with your pedia para mamonitor ng maayos ang cough and colds niya.

[ankyneMD]

thank you doc for answering. Ang sarap po magtanong sa inyo, very detailed ang mga paliwanag niyo. Nakaluwag po ako, na hindi pc ang cause ng cough ng daughter ko.
What about the adult doc, need po ba mag-clear ng xray ng isang adult with tb after the medication?
After 6 months of taking anti tb meds eto po ang result ng xray:
Follow up study shows further regression to partial clearing of the right upper lobe infiltrates, with only minimal linear densities noted. Kaya pinaextend ng another two months ang medication ng dad ko

And after completing the total of 8 months of taking meds, heres the xray result:
Giving due allowance to exposure factors, follow up chest xray shows no significant change in the previously noted ptb densities in the right upper lobe. Kaya pinaextend ulit ng 1 more month ang meds for total of 9month. And after that ok na daw ang dad ko. Ok na po ba yun doc kahit di nagclear ang xray? Tia.

[leletmd]

^ You don't need to have a repeat chest xray done as a basis for stopping meds. What is more important is clinical improvement. Sabi nga, we don't treat the labs/xrays. We treat patients. 

[rhylie10]

Good day dra. lelet, nahanap ko din tong thread na to, nakalock na po pala yung thread 2, yung daughter ko po is stop na po taking medicines nung December 31, then tomorrow po yung repeat x-ray po niya, then Thursday po babasahin ng pedia niya, sa mga nabasa ko po ditto ulit, possible po pala na mainfect ulit or magka PC ulit daughter ko kahit nagka PC na siya, gaano po katagal ulit? I mean hindi po kasi kami nagpa-xray yung mga kasama po sa bahay, di po kasi kami sinabihan ng pedia niya, what if lang po, natapos nga po sa gamut yung anak ko nung December 31, then meron pala isa sa amin ang nakahawa sa kaniya, lola po niya kasi bantay sa kaniya, then ako po at papa niya kasama sa bahay, since hindi alam yung source at natapos po pagtake ng gamut niya mauulit po ba yun? or pag nagpa-xray po ako at nakita meron ako at nagtake ako ng gamut, mahahawa pa po ba siya ulit since tapos na po siya nagtake ng medicines for six months?
second question po is, nabasa ko din po yung BCG vaccine, found out po na dapat pala may reaction yung BCG vaccine nung baby siya? yung pus or nagsugat? wala po kasing ganung reaction sa baby ko nun, paano po yun? thanks po.. god bless

[rhylie10]

sorry dra. lelet may reply po pala kayo sakin sa thread 2 nasa unahan po pala..hehe pasensya na po.. will wait nalang po ulit sa reply niyo sa new post ko.. thanks po

[leletmd]

^ There is a possibility of recurrence once her immune system resistance gets down again if she gets constantly exposed to someone with TB so I highly suggest that you have all her household contacts get a chest xray to determine kung sino ang nakahawa sa kanya.
With BCG, there are 2 schools of thought regarding the scar. Meron group na nagsasabi na kapag walang scar, dapat ulitin. Meron naman nagsasabi na ok lang kahit walang scar basta sure na nabigyan ng BCG.
Anyway, when we repeat the giving of the BCG vaccine, if the baby is more than 3 months of age, we usually test for TB exposure first. If positive ang PPD ng bata, we don't give the BCG vaccine anymore so in your daughter's case, hindi na siya kailangan bigyan ng BCG kasi nagkaroon na siya ng PC.

[rhylie10]

thanks dra. lelet for the reply, now I understand.. thanks.. nagpa x-ray na po ulit siya kahapon, maya po check-up, nagpa x-ray na din po ako kahapon, baka po kasi ako meron dahil nung nag stay po samin hipag ko, yung daughter ko naman po nasa province nun, baka ako po nahawa sa hipag ko then nung inuwi na po ulit daughter ko dito baka sakin nakuwa kasi that time wala na din naman hipag ko sa bahay.. hay sana po negative ako.. sa x-ray lang din po ba malalaman pag sa adult? thanks po

[leletmd]

^ Aside from chest xray, you can have a PPD test and a sputum test done.

[rhylie10]

good pm po dra.lelet, done with her follow-up check-up last Thursday, got my chest x-ray result, and sabi po ng pedia niya ok naman daw po yung sa akin, then yung x-ray naman po ng daughter ko heal na daw po, pero may mga kulani pa din daw po kaya parang doubt pa, lumiit naman po yung kulani, and simula nung nag take po siya meds di na po siya lagi nilalagnat at inuubo at medyo nag gain po ng weight, kaya stop na po yung meds niya ngayon pero obserbahan pa din daw po, tapos po asked him about vaccines, kulang pa daw po siya sa mmr, kasi po 9 months measles and MMR ok na po, meron pa po daw MMR with booster kaya ayun po ininject sa kanya.. about naman po sa built ng katawan ng daughter ko baka po talaga di siya tabain, 14.1 lang po weight niya 3 yrs old na po siya..

[rhylie10]

good afternoon po dra. lelet, got the final result of her chest x-ray yesterday, last thursday po kasi wala pa yung result ng radiologist, yung plate lang po hiniram namin para mapakita sa pedia ng daughter ko, and then sabi nga po ng pedia niya nagheal naman na daw po, so stop yung medicines, pero may kulani pa din po sa neck but maliit nalang po, base naman po improvement nag gain naman po siya ng weight pero konting-konti lang po, di parin po sakto sa age niya yung weight niya po, sabi nga po baka hindi po talaga siya tabain, but when we got the result yesterday ganun pa din po nakalagay like sa result ng x-ray niya nung may 2013,  ito po:
DIGITAL CHEST (AP/LAT) PEDIA
previous film dated May 05, 2013 reviewed.

Present study shows infiltrates in both lung fields.
Enlarged tracheobronchial lymphnodes are seen.
Heart is not enlarged.
Diaphragm and costophrenic sulci are intact.

IMPRESSION:
Consider bilateral interstitial pneumonic process with lymphadenopathy. PLEASE CORRELATE.

yan po yung nakalagay sa result ng x-ray niya base from sa nagbasa, di po nadiscuss ng pedia namin yun kasi po nung thursday plate lang po ang tinignan. worried lang po, kasi po yung result halos same lang din sa x-ray niya last May 2013. do i need to consult another pedia? or ok naman po yung pulmo-pedia namin na stop na yung gamot? di man po ako marunong magbasa ng x-ray pero nung nakita ko yung film compare ko siya medyo mas clear siya ngayon pero may konti pa po.. will wait for your reply dra. thanks and god bless..

PS
alam ko po out of topic, ask ko lang po yung sa DPT vaccine kasi meron an po siya sa center naka-3 vaccine na po siya dun, pero iinject parin daw po siya ng pedia niya ng DPT, ilang shots po ba ang DPT? thanks

[leletmd]

^ I think you should trust the judgement of your pedia pulmo regarding the decision to stop meds since she is the one who was able to see your child's progress from start to finish. Also, as I said before, we don't really rely on the chest xray with regards to stopping meds since there is such a thing as "radiologic lag" wherein chest xray results show little improvement despite clinical improvement. So clinical improvement pa rin ang dapat tingnan: nawala ba ang initial niyang symptoms? Hindi na ba siya sakitin? Nag-improve ba ang well being niya? Acitivty? Wieight/appetite?

There is a vaccination thread. Doon ko na lang sasagutin ang question mo regarding DPT para hindi tayo mapagalitan ng mods.

http://www.femalenetwork.com/girltalk/index.php/topic,265385.msg7747700.html#new