CHAPTER III CASE ANALYSIS Pulmonary tuberculosis is a cronic infection in lung, its caused by Mycobacterium Tuberculosis, characterized by granuloma

transformation and hypersensitivity type IV. Its common spread by Tb persons with AFB (+) in their pleghm.3 Diagnosis of pulmonary tuberculosis according to symptoms, sign, physical examination, thorax photo, AFB (+) in sputum and laboratory findings. Symptoms of pulmonary tuberculosis divided into systemic and respiratory symptoms. The systemic symptoms are fever, night sweat, malaise, and loss of appetite and body weight. Respiratory symptoms are cough, dyspnoe, and chest pain.2 Diagnosis according to physical examination is depend on wide and structural abnormality of lung. Phisical examination can normal in minimal lesion, Abnormality site common at apical/ posterior upper lobus and apical of lower lobus.We can find abnormality such as not symmetry of chest, increased of stemfremitus, stonydull in percussion, decreased of vesicular, rales moist (+).1 Sometimes the first indication of tuberculosis is an abnormal chest x-ray or positive tuberculin skin test (also known as a Mantoux test or PPD for purified protein derivative), because these tests are often done as routine screening tests. When a person has symptoms that suggest tuberculosis, a chest x-ray is taken, a tuberculin skin test is performed, and a sputum sample is sent to the laboratory. The sputum sample is examined under a microscope to look for tuberculosis bacteria and used to grow the bacteria in a culture. The microscopic examination is much faster than a culture but is less accurate. Cultures do not provide results for many weeks because tuberculosis bacteria grow slowly. In this case, patient come with symptoms such as cough with greenyellow pleghm, shortness breathing, fever, night sweat, loss of appetite and decreassed of her weight that show she has tuberculosis symptoms. Signs of tuberculosis are also

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found in physical examination such as in her lung, we found stony-dull in all area of lung and rales moist (+) all area of lung in auscultation . Her laboratorium finding AFB I, II, III are positive show that in one field of view contain >10 M. Thorax photo shows infiltrat in all area of lung, thats mean this patient is patient with wide lesion tuberculosis. Patient dont have history of comsuming OAT, so this patient included in new case of tuberculosis. Diagnosis of this patient is lung tuberculosis in wide lesion for new case and for her therapy, OAT category I, OBH syr for relieved her cough, and diet more calorie and protein.

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