tuberculosis 5

DIAGNOSIS

According to the American Thoracic Society, definitive diagnosis of tuberculosis tuberculosis is found with the bacteria Mycobacterium tuberculosis in sputum or tissue culture for tuberculosis.
Tuberculosis in the diagnosis of tuberculosis should be included clinical status, bacteriological status, and status radiologist status kemoterapI.
HANDLING
How Terapy pharmacology with Anti Tuberculosis Drugs (oat).
Principles of treatment:
TB drugs are given in the form of a combination of several types, in sufficient doses and appropriate for 6 - 8 weeks, so that all bacteria (including persistent bacteria) can be killed. Dose of intensive phase and continuation phase doses swallowed as a single dose, preferably on the stomach is empty.

TB treatment was given in 2 phases, namely:
1. Intensive phase.
Initial intensive phase, with activities bactericide that destroy the bacteria that split the population quickly. At this stage, the patient swallow the medicine every day and begins immediately to prevent the occurrence of resistance against all oat, especially rifampisin. When the intensive treatment phase is given exactly, the patient does not become contagious infectious within 2 weeks. Most people with TB BTA positive BTA become negative (conversion) at the end of the intensive treatment.
2. Advanced stage.
Advanced stage, with the sterilization of bacteria on short-term treatment or activities bakteriostatik on conventional treatment. At this stage, is important to kill bacteria, so preventing the occurrence of persistent relaps.

Type of Anti Tuberculosis Drugs (oat);
1. Isoniasid (H).
Known with INH, is bactericide, can kill bacteria 90% of the population in a few days treatment. This drug is very effective against bacteria in metabolic active, the germs that are growing. The recommended daily dose of 5 mg / kg of BB, while for intermittent treatment given 3 times a week dose of 10 mg / kg BB.
2. Rifampisin (R).
Bactericide be, can kill semi-dormant bacteria, which are not killed by isoniasid. Dose of 10 mg / kg of BB for the same treatment given daily or 3 times a week intermiten.
3. Pirasinamid (Z).
Are bactericide, the recommended daily dose 25 mg / kg of BB, while for intermittent treatment given 3 times a week with a dose of 35 mg / kg BB.
4. Streptomycin (S).
Are bakterisid. The recommended daily dose of 15 mg / kgBB medium-kan intermittent to treatment 3 times a week used the same dose.
5. Etambutol (E).
Are as bakteriostatik. The recommended daily dose of 15 mg / kg BB.

Oat Guide in Indonesia:
WHO and IUATLD (International Union Against Tuberculosis and lung Disease) guidelines recommend a standard of treatment with FDC tb:
1. Category Medicine
A. Category 1 (2HRZE / 4 H3R3)
Indications:
- People with a new positive TB Paru BTA
- People with new TB pulmo's BTA negative / positive rays (light & heavy)
- People with TB paru Extra
B. Category 2 (2HRZES / HRZE / 5 H3R3E3)
Indications:
- People with new TB Paru BTA positive relapse
- People with a new positive TB Paru BTA failed
- People with TB defaulter is used again with a positive BTA
C. Category 3 (2HRZ/4H3R3)
Indications:
- People with a negative BTA new and positive pain light rays.
- People with extra light tuberculosis, TB that is limfe gland, exudate unilateral pleuritis, TB skin, joints, and adrenal gland.

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tuberculosis 4

Clinical manifestations

anamnesis
Complaints that can be enjoyed by people with diverse, which was
1. Fever; fever can occur and is usually lost accompany influenza (subfebril).
2. Cough; nature of the onset of cough, dry cough (non-productive) and arising after infection to be productive (produces sputum). The situation is that the form of coughing up blood (hemoptoe) because there is a broken blood vessel.
3. Shortness of breath; Sasak disease found in the breath that is information, which is half the infiltrasi lungs.
4. Chest pain, chest pain arises when the inflammation is infiltration to the pleura so that the cause pleuritis.
5. Malaise; Symptoms include malaise often found: anorexia, no appetite, the body lean (body weight down), headaches, fell dizzy, muscle pain, night sweat, and others.

Physical examination
Place aberration is the most suspect part apex (top) tuberculosis. When suspected of infiltrate a rather broad, it was found that perkusi dim auscultate voice and breath brokial. Cavities when there is a large, perkusi vote hipersonor or timpani and auscultate vote amforik. Will also include additional breath sounds ronkhi wet rough and loud.

Vetting radiologist
- Shade lesi located in the field over the lung segment or apical lobus under cloudy shadow form (patchy) or The speck (nodular) or shadow milier.
- The kavitas, single or double and / or the kalsifikasi.
- Shadows live image on the back a few weeks later.

Vetting laboratory
1. Blood
At the time of starting a new tuberculosis (active), will be lekositosis with differentiation shifting left, limfosit below normal, LED increases.
2. Sputum
BTA criteria sputum is positive when at least 3 rod bacteria found on the BTA a sample. In other words needed 5000 bacteria in 1 ml of sputum.

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tuberculosis 3

Classification
1. Tuberculosis Lung.
Tuberculosis Tuberculosis Tuberculosis is the network of tuberculosis, not including the pleura.
2. Extras Lung Tuberculosis.
Tuberculosis that attacks the organs other than tuberculosis, example pleura, peritoneum brain, pericardium, limfe gland, skin, intestine, ureter, and others.

Type People
Based on previous treatment history, that is;

1. New cases
Are people who have not been previously treated oat, oat or been treated less than a month.
2. Relapse (Relapse)
Are people who previously never got treatment and was declared cured, and then back again with the treatment results of sputum examination positive BTA.
3. Delinquent and drop out.
People who already get most of 1 month or less, and stop for 2 months or more, and then come back treatment. Delinquent and drop out may be caused by factors disloyalty, have been cured or feel better, or economic factors.
4. Failed.
Is that from the start of treatment until the end of treatment still showed positive results of BTA. BTA or people who are positive or positive on the back end of the fifth week, or can also BTA patients with negative, positive rays into BTA positive at the end of the second treatment.
5. Many drug resistant (Multi drug Resistant).
This can be caused by the negligent and the patient drop out who repeatedly undergo the same treatment.

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tuberculosis 2

DEFINITION
Tuberculosis (TB) disease is an infection caused by Mycobacterium Tuberculosis infection. Bacteria that are dormant can rise again and make more active tuberculosis.

ETIOLOGY
The cause is Tuberculosis Mycobacterium tuberculosis, the type of rod-shaped bacteria with length 1 - 4 / Um, thick and 0.3 - 0.6 / Um. Most of the bacteria consist of fatty acid (lipid). Lipid is what makes bacteria resistant to acid and more resistant to chemical and physical interference.
Bacteria can quickly die with the sun directly, but can survive several hours at the dark and humid. Nature of other bacteria is aerob.

PATHOGENESIS
1. Primary infection
Primary infection occurs when a person was first exposed to the TB bacteria, entri the droplet size is very small, so the system can pass defense mukosislier bronkus, and continue to run until the alveolus and settled there.

2. Post Primary Tuberculosis
Post-primary tuberculosis usually occurs after several months or years after primary infection.

Natural history of TB patients not treated:
- 50% died
- 25% will recover with your own body resistance is high
- 25% will become chronic cases, which remain infectious

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tuberculosis 1

Diseases Tuberculosis (TB) is a disease that is easily spread in recent years show an increase in the number of new cases and the amount of mortality caused by TB.
WHO reported the existence of 3 million people die due to TB each year and estimated 5000 people each day. Regional Southeast Asia bear the heavy part of the global burden of TB around 38% of TB cases worldwide. SKRT in Indonesia based on the department of healthy in 2001, each year found 583,000 people with tuberculosis (TB) and 50% of them (296,000) is the category of acid-resistant bacillus (BTA) is a positive spread, a result 140,000 people die each year.
TB is a burden on the community which is very heavy. This is marked with a prevalence of 13 per 10,000 population (the results of research in 16 provinces in Indonesia in the years 1979-1982 and 1983-1993), one of BTA (bacillus Acid Resistant)-positive can transmit to 10-15 people per year.
TB disease is a problem not only individuals but society has a problem. Pain, and death due to TB have significant consequences for both economic problems of individuals, families, communities, companies and countries.

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