Childhold tuberculosis

Azwar Lazuardi

1
 Introduction
Tuberculosis (TB) is an infectious
disease caused by Mycobacterium
tuberculosis.
Generally, TB attacks the lungs, so
called pulmonary TB.
In contrast to adult TB, the symptoms
of childhood TB are often not typical.
Diagnosis must be established by
finding TB germs
2
 Definition
Tuberculosis (TB) is an infectious
disease caused by Mycobacterium
tuberculosis.
Tuberculosis in children is defined as
tuberculosis suffered by children <15
years.

3
 Epidemioology
In2010, Indonesia was ranked the
4th country with the highest
incidence of TB in the world as much
as 0.37 to 0.54 million

4
Etiology
Cell walls that are rich in
lipids make these bacilli
resistant to bactericidal
action of antibodies and
complement
These germs can survive
in dry or wet air due to
germs in dormant state.
And from this dormant
state germs can reactivate
again.

5
 Inhalasi Mycobacterium tuberculosis

Fagositosis oleh
Kuman mati
makrofag alveolus paru

Kuman hidup
berkembang biak Masa inkubasi
Pembentukan fokus primer (2-12 minggu)
Penyebaran limfogen
Penyebaran hematogen

Uji tuberkulin (+) Kompleks primer

Terbentuk imunitas seluler spesifik

Sakit TB Infeksi TB
Komplikasi kompleks primer
Komplikasi penyebaran hematogen
Komplikasi penyebaran limfogen Imunitas optimal

Meninggal
Imunitas turun
Reaktivasi / reinfeksi

Sembuh Sakit TB
6
Gambar 1. patogenesis tuberkulodid (dibuat berdasarkan beberapa sumber)
 Clinical manifestation
1. Older fever (> 2 weeks) and / or recurring
for no apparent reason
2. Weight loss for no apparent reason
3. Anorexia
4. Enlarged superficial lymph nodes
5. Long cough for more than 3 weeks
6. Persistent diarrhea that does not heal
7. Malaise (tired, lethargic, weak, tired)

7
 Other manifestation
Depending on which organs are
affected
Skrofuloderma

Chest pain due to fluid in the pleura

cavity
Symptoms such as bone infection

High fever, decreased awareness and

convulsions (tuberculosis meningitis)
8
 ENFORCEMENT OF
DIAGNOSIS
Anamnesis
Reduced weight 2 months in a row for
no cause
Fever for no apparent reason
Chronic cough> 3 weeks
Contact history with adult lung TB
patients

9
 ENFORCEMENT OF
DIAGNOSIS
Physical examination
Enlarged lymph glands
Progressive swelling or bone deformity,
joints, knees, phalanges
Weight measurements by age

10
 ENFORCEMENT OF
DIAGNOSIS
Supporting investigation
a) Tuberculin test
b) Radiology
c) Microbiology
d) Anatomical Pathology

11
Scoring diagnosis system of
childhold tuberculosis

12
 Kalender perjalanan penyakit Tuberkulosis primer

Kompleks Primer
Sebagian besar
sembuh sendiri Erosi Bronkus TB Tulang
(3-24 bulan) (3-9 bulan) (dalam 3 tahun)
Pleural effusion Meningitis TB Ginjal
(3-6 bulan TB Milier (setelah 5 tahun)
(dalam 12 bulan)
INFEKSI

HIPERSENSIVITAS KEKEBALAN

1 tahun
2-12 minggu
(6-8 minggu)
Risiko tertinggi untuk

Risiko menurun
Komplikasi Lokal dan Diseminasi
13
Theraphy

14
Duration of therphy

15
 Dosis kombinasi pada TB anak
Berat badan (kg) 2 bulan 4 bulan

RHZ (75/50/150 RHZ (75/50 mg)

mg)
59 1 tablet 1 tablet

10 14 2 tablet 2 tablet

15 19 3 tablet 3 tablet

20 32 4 tablet 4 tablet

Catatan
Bila BB > 33 Kg, dosis di sesuaikan dengan tabel 1 (perhatikan dosisi maksimal).
Bila BB < 5 kg sebaiknya dirujuk ke RS.
Obat Tidak Boleh diberikan setengah dosis tablet.
Anak dengan BB antara 9 10 diberikan 1 tablet. 16
 PREVENTION
1. BCG Vaccination
2. Chemoprophylaxis
- Primary
- Secondary

17
TERIMA KASIH

18