Primary Complex Thread 3

[rhylie10]

thanks for the reply dra. lelet, about po dun sa tanong niyo sa improvement, di na po siya sakitin, kasi before po nung di pa namin alam na may PC po pala siya is halos monthly may lagnat at ubo, nung nagtake na po ng meds di na po siya lagnatin at ubuhin.. yung sa weight gain naman po nag gain naman po pero below average parin po yung weight, every follow up check up niya naman po tumataas timbang niya pero konting-konti lang po, sa pagkain po, picky parin po siya,,, thanks po.. kinabahan lang po kasi ako dun sa result ng x-ray na bilateral pneumonic

[leletmd]

^ Xrays kasi may show delayed improvement (radiologic lag) so it is important to base decisions on clinical findings pa rin. It sounds like your child has improved naman so trust na lang the judgement of your pedia pulmo regarding the meds.

[RAIN_2828]

hi doc, bago lang ako sa thread na eto  my baby was diagnose last january 12 na  may primary complex sya.. nun una wala akong kaalam alam ang buong akala ko lang its a normal ubo lang ang meron ang baby ko pero nun nilagnat sya 1time after noon dun ko n sya dinala sa pedia nga.nirequired kami ng chest x-ray . dun sa x-ray nya may nakitang hilar sa right chest nya or kulane..aside dun marami daw kaci nakakapa bukod sa ilalim ng tenga ng baby ko..after the x-ray nirequired naman kami ng PPD test ( skin test ) after 3 days bumalik kami sa pedia nya for the result at nakita yung pamumula sa skin ng baby ko at sinukat, ang result ay 9cm [textspeak!] pamumula that means positive sya..now nagmemedication sya for 6 months..ang nereseta saknya at yung kids kit 3.. her med taking 2 kinds evry morning pagising nya at 1 in the afternoon plus multivitamins and celin para lumakas ang appetite nya kasi underweight na sya..Now do.. 3 lang kami adult na kasama nya sa bahay..ako, lola nya at tito ( brother ko ) my brother was diagnose na may spot sa lungs nya during his medical at nagmedication ng 7days atibiotic lang po rsita sknya.after nun nag pa x-ray ulit sya at clear naman po..im thinking na possible po ba na nahawa ang baby ko dun sa brother ko na nagkaroon ng history na spot sa lungs..TB po ba yung ganun spot s lungs? pero kasi po naisip ko hindi naman daw un TB [textspeak!] sa brother ko kasi 7 days antibiotic lang sya e..co-amoxiclab pa nga po resita skanya e...i wonder saan nakukuha ng bata yung primary complex e bihira naman po lumabas ng bahay ang baby ko..please help me.do i need to ask my brother na magpachek sya ulit at mag pa x-ray na baka saknya galing yung primary complex na nakuha ng baby ko..sila lang kaso madalas magkasama sa bahay kasama ng mother ko.

[ankyneMD]

sis try mo magpaxray din and your mother din.

[LeAnEn]

Hi doc leletmd! Hope you could help me understand.  Is it possible for an adult to get an active TB if he had primary complex when he was still a child? kung baga nag auto reactivate yung treated pc nya dahil for example bumaba ang resistensya nya?

[leletmd]

^ Yes, re-activation is very possible. Primary complex refers to the first time a person encounters and develops a TB infection. Years after, pag bumaba ang resistensya, pwedeng mahawa ulit kapag na-expose ng matagalan sa isang tao na may TB.

@RAIN_2828:
I suggest you clarify with your brother regarding his xray findings. Before pag sinabi na may spot sa lungs ang isang patient, that usually refers to TB so best to clarify with him and check the xray results.
TB develops kapag matagalan na na-expose sa isang tao na may TB, so please have your mother and your self get a chest xray to check kung sino ang nakahawa sa anak mo. Aside from chest xray, you can also have a PPD test and a sputum AFB smear test done.
Before we blame passers by or neighbors or random strangers, it is important to check house hold contacts first kasi kayo ang matagalan na nakakasama ng anak mo.

[rhylie10]

morning po.. dra lelet yung daughter ko po nilagnat nung Friday until sunday I think.. may sipon din po, pero napainom ko na po ng gamot, pero since Monday until now pag gising ko po ng umaga pag nahahawakan ko siya may low fever siya.. and sabi niya nga po masakit daw yung neck niya dun sa may gilid ng neck below ng ear niya.. then pag lilingon po siya dahan dahan nga po, kinapa ko po dami po kulani and yung sinabi niyang part na masakit is namamaga po na kulani yata.. ehh tapos na po siya sa 6 months meds niya diba, then sabi naman po ng pedia niya is stop na yung gamot, bumalik po ba agad yung primary complex niya? January 9 lang po yung last check up niya eh.. kinapa ko po yung neck may mga lymph nodes po talaga at yung sabi niyang masakit is namamaga.. worried po ako.. ganun po ba kabilis bumalik? wala po kasi yung pedia niya ngayon, sa 27 pa po balik naming sa kanya for pneumococcal vaccine

[leletmd]

^ Not all enlargement of lymph nodes/kulani is due to PC.
As I mentioned several times in the past thread (maybe you can try to back read if you have time), enlargement of lymph nodes may be brought about by infectious and non - infectious causes. Any infection (bacterial, viral, fungal, mycobacterial) can bring about enlargement of the lymph nodes. Allergies, wounds/abscesses/boils, tumors , dental caries or sirang ngipin can bring about enlargement of lymph nodes. Even sipon can bring about enlargement of lymph nodes.
The reason why lymph nodes enlarge is because they are producing antibodies to counter the infection/disease.
The best thing to do is to have your child checked by her pedia. You can bring her earlier than scheduled since there is a pressing problem that needs to get checked.

[rhylie10]

thanks for the reply dra lelet.. dami po lymph nodes sa neck niya;( mya po papacheck up ko po siya.. thanks po ulit.. godbless

[cheniwin]

Hi Doc Lelet, My husband was diagnosed last yr after ko lang manganak, pero clear sputum nya and finished his medication. Then Jan this yr i have findings naman during our annul physical exam. Then nagpasecond xray ako, positive tb daw, so I went to a pulmo pedia right away to have my baby checked kc I was breastfeeding him for 8months na.
my baby is super healthy, never nagkasakit, even slight fever. Weight gain is super ok and growing really well so xray agad ang inadvised ni doc
result came, d daw nya masabi if positive or not,He cant read the result well!
Then skin test daw
we returned, sabi nya positive daw un skin, wala ako nakitang redness or bump whatsoever, I asked him how can he tell..may matigas daw under the skin nun turok and positive daw pala un xray
so ang gulo nya...I read threads na rin so i was hoping for just 1 med for 9mos
He prescribed medications for 6mos then enumerated damages to my sons liver, eye sights etc etc
Now I am more worried...I am not convinced my son is disease, exposed Oo
then why giving treatment that will give more harm kay baby? when he never had any problem since I gave birth to him. Ndi ko na po alam ang gagawin
Should I ask second opinion?

[leletmd]

^ What was your baby's response to the BCG vaccine? The BCG vaccine kasi is a good way of checking if your baby got infected during your pregnancy (even if after pregnancy mo na diagnose yung husband mo, it is possible he had it already during the pregnancy since matagal bago magdevelop ang TB infection). If the scar formed within 7 days from vaccination, then that is an accelerated response and it is possible that the baby developed the infection while in the womb. If the BCG scar formed within 4 to 8 weeks, then it is possible there is no infection yet.
Your baby is already exposed so whether or not the PPD is positive or negative, he still needs to treat for exposure. I think it is very important to check for disease, though, even if he has been a healthy baby all through out so my suggestion is to go for a 2nd opinion. Bring the chest xray results when you go to another pedia pulmo.

[twelve5]

Hi doc!

My nephew was just diagnosed with PC. The pedia instructed that everyone in the household gets xray done. Some of the kasama has had their xrays done 6 and 2 months ago, and all were clear naman. Do they need to have their xrays done again? How recent po ba dapat yung xray para malaman na di sya yung source ng TB?

Thanks in advance. =)

[leletmd]

^ In my opinion, even though they had chest xrays done 2 and 6 months ago, they should still have a repeat chest xray done. It takes time for the TB infection to develop so in that few months since clear ang chest xrays, pwedeng magkaroon na ng findings by now. Actually, when we ask for clearances, usually dapat within 2 weeks nagawa ang xray or else, dapat ulitin. Please ask na rin your pedia's opinion regarding this.
What is important now is to find out who the source is so that the source can also get treatment and stop infecting other people in the household.

[twelve5]

^ hi doc! Thanks!

one has this finding and impression, respectively:

Fibrotic densities are seen in the left upper lobe.

Left upper lobe densities probably residual from previous infection.

The pedia said it looks like no (current) infection. But just to be sure, she recommended to see a pulmo. We got 2 referrals but out of the country pa until next week. =(

May i ask for your opinion on this?

Also, lets say if nobody in the household is infected talaga, can a person be a carrier? Like, if may officemate ka palang may TB, when you come home pwede bang dala mo yung germs/bacteria and ikaw magkakalat sa bahay? I hope it's not a silly question. Hehe

TIA, doc! =)

[leletmd]

^ You can only spread the infection if you yourself is infected. Kung carrier man, meron pa rin infection pero hindi lang nagmanifest ang symptoms so may findings pa rin dapat sa chest xray.
Aside from chest xrays, pwede rin magpaPPD test ang mga household contacts to determine exposure. Kung meron postive sa exposure sa household aside from the patient, then definitely sa bahay nakuha ang infection.
Regarding the xray findings, since fibrotic na, most likely old infection. Pwede rin to have the sputum checked to see if meron pang live tb. I agree with your pedia in having a pulmo consult pa rin.

[twelve5]

^ ooooh, i see... Sige po doc, will tell them to have the skin test done also.

The pulmo will be back this week, so hopefully di sila jet-lagged and will hold clinic agad. Hirap din kasi to wait, pero we'd rather go to either of them kasi recommendado kesa pumunta sa random doctors.

Thank you so much, doc, for taking time to answer my queries. At least we know na what to expect,  like the sputum test.

Thanks! Thanks!

      

[xanmer]

Hi dra lelet.  Tanong ko lang po kung ano ang ibig sabihin ng findings sa xray ng 5-year old daughter ko- peribronchial lymphadenopathy. Kanina ko lang po kasi nakuha ang result.  Requirement po kasi sa school ang x-ray. Thank You.

[leletmd]

^ There are enlarged lymph nodes found in the peribronchial area. Most common cause would be infection. I suggest you bring your child to the pedia for clinical correlation. Bukod kasi sa chest xray findings, important din na mareview ang history ng anak mo and ma-examine siya to be able to tie up all the findings.

[bylan]

hi dra lelet! mag-consult lang po ako..... i am based overseas and dito ko na rin pinanganak daughter ko..she is almost 10 months old now...plan po naming umuwi ng Pilipinas to visit our relatives and makilala nila si baby......ang mother in law ko po ay may PTB and ginagamot sya ngayon..... on and off po PTB nya....ang fear ko po is baka mahawa si baby pag-uwi namin...wala rin po BCG si baby since itinigil na po ang pagbibigay nito dito...

ano po mai-suggest nyo sa amin? magrequest po ba nabigyan sya BCG bago kami umuwi? sa tingin ko po di maiwasan na lumapit si baby sa mpther in law ko....TIA

[leletmd]

^ How long has your mother in law been receiving treatment for PTB? Is she compliant with her treatment? What do you mean by on and off na PTB? Did the other household members get tested for PTB, too?
Technically, if more than 2 weeks na since start of treatment and your mother in law is compliant with her medications, she is no longer contagious. However, other household members should also be tested to determine if meron ba siyang nahawaan before treatment or kung sino ang nakahawa sa kanya. Whoever gets positive results for PTB should also receive treatment.
Ang recommendation dito regarding giving the BCG vaccine beyond 3 months of age is to do testing for TB prior to giving the vaccine. If negative PPD and chest xray, then pwede bigyan ng BCG. The reason for testing before vaccination is to check for exposure. If may positive na exposure na, it would be better to treat than give BCG.
Ask na lang your pedia there kasi baka iba ang recommendations nila regarding BCG vaccination.