Primary Complex Thread 3

[forumera]

@forumera:
The patient should be brought to the pedia before the 6 months is up for re-assessment. Usually, we rely on clinical findings: there should be improvement of initial symptoms such as after 6 months, lumiit na yung mga lymph nodes, mas magana na kumain, hindi na sakitin, etc. Chest xray is only done if hindi malaki ang improvement or if there is not much change from initial symptoms.

sis doc, after 3 months or 2 months ata ng gamutan  dinala ulit sa pedia, pinalitan pa nga yung medicine e, I mean, same gamot pa din pero sa umaga na lang itetake. Paano malaman if lumiit na mga lymph nodes? Magana naman kumain sis, always magana kumain, siya pa nagsasabi I'm very hungry kahit kakakain lang haha, hindi rin naman sakitin, di ko na matandaan kelan last lagnat, sipon or ubo niya e.

Ang worry ko kasi sis, nung morning and evening pa ang take niya ng gamot, yung evening minsan hinde nate take like 1 out of 10, ganun, or minsan late na nate take, kasi umalis kami at late na nakauwi, like dapat 7pm, nagiging 11pm.

eto naman naging morning lang ang intake, sabi di ba 1 hour before bfast, tinetake niya 6am or 630am then 7am kumakain na siya cereals.

PS: bw*set, dami ko nitype tapos error daw, buti pag back ko hindi nawala. hay GT

[leletmd]

^
Ideally, while on PC treatment, the child comes back for monthly check ups to assess response to the meds and to check for possible adverse reactions to the medications.
How is response assessed? Depende kasi sa initial symptoms: why was PC suspected and how was it diagnosed?
Yung pag liit ng lymph nodes, the doctor will assess that during monthly check ups.
Pang ilang month na ba niya on PC meds?
Bottomline is, before you stop the PC meds, dapat may re-assessment na ginawa ang doctor. The doctor who assessed and diagnosed the child is the best person to do the re-assessment.

[cjoann08]

@leletmd

Hi! Po Doc Lelet . Thank you and nakita ko po ito forum na ito. Meron [textspeak!] po sana ako gusto itanong about sa gamot na Rimaped and Isoniazid. My son is 6 years old, I gave him this morning the Rimaped 6:20am and isoniazid 7:05am, tapos po [textspeak!] first urine niya  red and the whole day of [textspeak!] urine na po niya is orange yellow na parang konti red. Normal [textspeak!] po ba iyon? natatakot po kasi ako baka magka problem siya sa liver or kidney. Thank you po.

[leletmd]

@cjoann08:
Were the side effects of the medications explained to you?
Common side effect of taking rifampicin is to have red orange urine, sweat and tears. It doesn't mean there is kidney or liver damage happening.
If the side effects were not properly explained to you, I suggest you go back for follow up.

[jhen_jhen]

hello po doc lelet..
kc un byenan ko 3 weeks n dw ubo nya, then ngpachekup..
tpos nag xray..cavitary ptb lang po un nttndaan ko sa result nun pinakita smin.
nag pa sputum test, pro negative po..
bnigyan dw po sya sa asian hospital ng meds for 6 months.
pwd po ba un n positive sa xray but negative sputum test?
worried lang po ako kc nagka primary complex na anak ko nun 2015.
bka mahawa kc at magkaron nnman.., though pg sunday lang nmin cla nkikita sa church.
need dn ba nla lahat pa xray sa bahay? hindi nman dw po kc sinabi kung mag isolate sya or pacheckup un iba members..
nkaka paranoid na kc pg magkakasakit mga bata..hirap dn mgpainom gmot.

additional question po, 
kasi,yung pastor namin sabi nila positive din daw po sa xray.
binigyan din po ata ng meds pero inistop dw po after malaman na negative naman ang sputum test at kesyo wala na daw po syang ubo.
nakakalungkot lang kc baka sa kanya pa nahawa yung byenan ko.
paano po pag ganun na nagstop ng meds..pwede pa ba sya mag take ulit or paano po ang ggawin sa knya kasi baka makahawa pa ng iba lalo madami po bata sa church.
hindi ko po alam kung in denial stage sya or sabi nya wala na yon at pinagaling na ni Lord.

thank u po in advance..

[leletmd]

 @jhen_jhen:
There are cases wherein the xray is positive but the sputum tests turn out negative. Pwede kasi hindi good specimen ang binigay. Did they do afb culture? Culture results take about 2 months to be released because it takes a while for the tb bacilli to grow.
Sa cavitary Tb, usually nagform na ng air space or cavities sa lungs due to persistence of the TB infection. Nakakahawa ang cavitary TB. Once treatment is started and taken with good compliance, nababawasan ang pagiging contagious within 2 to 4 weeks.
All of the members of your byenan's household should get a chest xray. 
Were you able to find out the source of your child's PC before?
Re your pastor, sya ba ang nagdecision magstop ng meds or it was advised by his doctor? It would be best for him to go for a follow up check up with his MD.

[jhen_jhen]

hi po doc lelet. sinabi din daw po sa kanya na stop na nung nag negative ang sputum. parang sa center or kung saang clinic nga lang po sila nagconsult.  sa ngayon po mukang wala naman na nga sya ubo pero nakakaworry pa din po. hindi din po namin alam paano iaaproach sa pastor.

yung sa anak ko po, hindi ko po alam yung source. hindi ko dn po kasi alam na dapat hanapin ang source. nun naconfine po kasi anak ko march 2015, pneumonia daw..kaso hindi po nagiimprove so advise ni pedia palitan gamot..nag ok naman po.. nag x-ray pero hindi ko po nakita results non... tapos bibigyan daw pampatibay ng pulmon..which is kids kit 3..then nadischarge kame..sabi ng tita ko pang PC nga daw po un..nashock ako kasi wala inexplain saken basta pampatibay daw po pulmon.hai..nagfollow up kame,ni clarify ko po yun gamot, pang PC daw nga po..usually daw pag hindi nagrerespond sa pneumonia meds,tinitreat nila for pc.. 6 months treatmentbpo, nagimprove naman anak ko..nakakainis lang kasi wala masyado ineexplain..na dapat may ppd or xray pa..yung bunso ko isoniazid ang binigay non for propylaxis at prevention daw. hindi din sinabi na need namin hanapin ang source..buti pa po dito sa forum madami ako natutunan. gusto ko na nga din pa xray para makasigurado wala ako tb..
yung asawa ng byenan ko inuubo ubo na din po..baka nahawa na.. ayaw pa magpatingin..
thank you po doc sa time..madami ako natututunan dito sa forum.

[m_lim]

doc leletmd,

yung yaya namin dati nagka TB, nahawa ang first born ko kaya pina alis ko muna. pinabalik ko siya ngayon but before that, pina afb culture ko, negative.

manganganak ako ulit next month. sure na sure na ba na 100% magaling na siya? pina sputum, x ray ko din siya. negative sa sputum but x ray forever na daw may "scar" kumbaga kaya hindi reliable.

anong maintenance kailangan ko gawin like yearly kailangan ba ipa AFB culture para sigurado hindi na babalik ang TB?

thank you in advance!

[leletmd]

@ jhen_jhen:
It takes months of exposure for TB to develop and if it's cavitary TB, it means there was a previous infection na before so your byenan might have had the infection na way before.
Best to have everyone in the household undergo chest xray.

@m_lim:
You can have annual 3 day AFB smear. Faster release of results compared to culture.
Make sure also your yaya has a strong immune system. If her immune system is weak, there's increase chance of the TB coming back.
How old is your yaya? Does she have other illnesses/diseases like Diabetes, hypertension or thyroid disease? If may Diabetes kasi, mababa ang immune system and slower healing process so dapat controlled ang blood sugar.

[m_lim]

^she's 54 na. yes diabetic pa. hay, kung may mahanap lang na iba. kaso ayaw ko kumuha ng di ko kilala.

thank you so much doc! kailangan ko din pala monitor blood sugar niya. magastos

[jhen_jhen]

naku doc, yung byenan ko my diabetes at highblood din po.. un sinusitis nya lumala din.. sabi nga daw po pag hindi gumaling diabetes nya, hindi daw gagaling tb nya..  matagal po ba mawala ubo ng my tb...kasi nakaka 1 month na po ata siya nagtatake ng meds kaso yung ubo parang hindi nawawala.

[leletmd]

@m_lim:
You're welcome. Yes, please monitor her blood sugar regularly as poor blood sugar control may bring down her immune system and it also delays healing.

@jhen_jhen:
Poor blood sugar control can delay healing. Please advise her to go for follow up check up if her cough hasn't improved yet.

[Rofia0424]

Hi po! ask ko lang kung may aka experiance na po dito na tapos na ang 6 mos treatment tapos nung pinag repeat xray ang result ng xray ay "slight regression" lang.. ibig bang sabihin hindi pa gumaling ang primary complex ng anak ko..?

[skyevonne]

Good day. My son was diagnosed of PC when he was 9months old.tinapos nya 6months na gamutan then inadvice na kme to stop.hindi na sya sakitin after that. Tapos ngayong 5yrs old na sya na diagnose ako ng TB. Malakas kutob ko sa kapatid ko ako nahawa. na expose din mga anak ko..and 3weeks na ko nggagamot .pina check ko dalawang anak ko.Yung xray ng 5yr. Old son ko na nagkaroon na ng  PC nung 9months sya Normal Chest xray ang result clear lungs nya.pero may kulani dw sya kaya niresetahan parin ng anim na buwang gamutan..susundin ko ba sya?

[highness127]

Sis, kulani lang po ba basis nya? If you want pa sputum test sya and PPD just to further confirm. Irequest nyo nalang kay doctor nyo.

[hushush]

^^if may perihilar lymph nodes, categorized yan as lung infection. Ganun kasi sa anak ko nun 4yo nagka-PC din. But since namedicate na anak mo secondary infection na ata yun.
Pano naging normal ang chest xray na may kulani?
Yun sa anak ko nga negative sa PPD test. Tapos kaming mga kasama nya sa bahay negative din sa xray.
Malalaman mo din naman pag may tb ang bata pag pumapayat kahir anong kain at pawisin lalo pag gabi.
Yun anak ko ngayon di ko pa napaxray ulit pero 6yo na sya ay napakataba nya ngayon unlike nun may PC sya na 19kg lang sya @4yo. Ngayon 30kg+ na sya at 6yo.

[lanieb1]

Doc lelet,

Good Day!

My son is taking medicine for his primary complex for 2 weeks na po (isonazid,rifampicin,pyrazinamide at ethambutol) 2 yrs na po c baby.. He was diagnosed a month ago due to poor weight gain, pabalik balik na ubo at ngpositive po [textspeak!] sa PPD then [textspeak!] xray result po is pneumonia bilateral. nung time po na ngstart na po [textspeak!] mgtake ng gamot bgla po ngkaroon [textspeak!] ng ubo at nilalagnat so we decided na mgfollow up sa pedia and ngprescribed po ng antibiotic pra dun sa ubo. after a couple of days nwala nman na po [textspeak!] ubo nia at lagnat, ngaun nman po nilalagnat [textspeak!] at nduduwal at ngsusuka. suspect po nmin is sore throat. ngtataka [textspeak!] po kami simula po nung ngstart [textspeak!] mgtake ng gamot sunod sunod po [textspeak!] skit nia.

[arnie ortiz]

Ask ko lang po if nag positive sa tb skin tapos negative po un Xray my PC na po ba yun bata?

nag second opinion po kasi kami sa Health center sabi samin hindi naman daw po kasi my question po sila na ni ask ng negative naman po dun yun anak ko.

natakot po kasi ako sa dami ng gamot at [textspeak!] naman pong my TB samin..

help naman po..

[weng.totz]

Last year nagka asthma attack anak ko tapos sabi namin sa pedia pabalik balik ang asthma nya. so yun x-ray at ppd kami. sa ppd negative sa xray may perihilar lymph nodes.

nagreseta sya ng gamot pero hindi namin binili. tapos madalas syang may ubo at sipon. geez.

[highness127]

Mga mommies, may 5 criteria po to consider para maconclude yung primary complex. Kapag confirmed yung 3 criteria dun po usually nasasabing positive po sa PC ang bata. Better ask your pedias about it.

Sa case ng kid ko before:

1. PPD skin boundary yung kanya 10mm so +
2. Inuubo ng more than 2 weeks na so +
3. Yung yaya ay may TB so talaga naconfirm na +