e-ISSN 2147-2475
Cilt : 8 Sayý : 3 Yýl : 2022

Hýzlý Arama




Laparoscopic Endoscopic Surgical Science Ýmmünkompetent Bir Hastada Masif Yaygýn Tüberküloz: Endemik Bir Ülke Endonezya'dan Erken Taný ve Ampirik Tedavi Yaklaþýmý (Olgu Sunumu ve Literatür Deðerlendirmesi) [Respir Case Rep]
Respir Case Rep. 2019; 8(3): 86-93 | DOI: 10.5505/respircase.2019.09825

Ýmmünkompetent Bir Hastada Masif Yaygýn Tüberküloz: Endemik Bir Ülke Endonezya'dan Erken Taný ve Ampirik Tedavi Yaklaþýmý (Olgu Sunumu ve Literatür Deðerlendirmesi)

Allen Widysanto1, Audrey Suryani Soetjipto2, Nata Pratama Lugito3
1Siloam Lippo Village Karawaci, Pelita Harapan Üniversitesi, Göðüs Hastalýklarý Bölümü, Tangerang, Endonezya
2Pelita Harapan Üniversitesi, Pratisyen Hekim, Tangerang, Endonezya
3Siloam Lippo Village Karawaci, Pelita Harapan Üniversitesi, Ýç Hastalýklarý Kliniði, Tangerang, Endonezya

Tüberküloz (TB), yüzyýllardýr bu hastalýðý yenmek için verilen çabalara raðmen hala yaygýndýr. Endonezya, saðlýk hizmetlerine; özellikle de yüksek derecede duyarlý ve spesifik moleküler araþtýrmaya eriþime eþit olmayan bir daðýlýmýyla, dünyadaki toplam TB yükünün en yüksek olduðu üçüncü ülkedir. Enfeksiyonun kontrol altýna alýnmasý için hýzlý ve doðru TB tanýsý çok önemlidir. ARB smear testi (balgam yayma), kolayca eriþilebilir ve uygun maliyetli bir testtir. Ancak, bazý eksiklikleri vardýr. Akciðer, perikardiyal, peritoneal, utero-over, genitoüriner ve dalak tutulumu ile ikinci basamak bir saðlýk tesisine baþvuran, öncesinde saðlýklý 23 yaþýndaki Endonezyalý bir kadýnda, ARB yayma negatif dissemine tüberküloz (TB) saptadýðýmýz olguyu sunuyoruz. Klinisyen, hastanýn kliniði ve hastalýðýn endemik epidemiyolojisini göz önüne alarak, pozitif mikrobiyoloji ve tanýsal biyopsi sonucu olmadan anti-tüberküloz tedavisine baþlamayý tercih etti. Anti-tüberküloz tedavinin baþlanmasýndan 2 ay sonra ortaya çýkan pozitif mikobakteriyel kültür ile taný doðrulandý. Ayrýca, diðer ülkelerden bildirilen 20 adet immünokompetan dissemine tüberkülozularý da inceledik.

Anahtar Kelimeler: yaygýn tüberküloz, taný, endemik, immünkompetent

Massive Disseminated Tuberculosis in an Immunocompetent Patient: Early Diagnostic and Empiric Treatment Approach from an Endemic Country: Indonesia (A Case Report and Literature Review)

Allen Widysanto1, Audrey Suryani Soetjipto2, Nata Pratama Lugito3
1Department Of Pulmonary And Respiratory Medicine, Siloam Lippo Village Karawaci, Pelita Harapan University, Tangerang, Indonesia
2General Practitioner, Pelita Harapan University, Tangerang, Indonesia
3Department Of Internal Medicine, Siloam Lippo Village Karawaci, Pelita Harapan University, Tangerang, Indonesia

Tuberculosis is still rampant, despite the centuries of efforts to conquer it. Indonesia is host to the third highest TB burden in the world, with an uneven distribution of health care access, and especially to highly sensitive and specific molecular investigations. Rapid and accurate TB diagnosis is crucial for the control of the infection. An AFB smear test is easily accessed and is cost-effective, although there are a number of shortcomings with the approach. We report here on a case of negative acid-fast bacilli (AFB) smear disseminated tuberculosis (TB) in a previously healthy 23-year-old Indonesian female who presented to a secondary care facility with pulmonary, pericardial, peritoneal, utero-ovarian, genitourinary and splenic involvement. The clinician chose to start anti-tuberculosis therapy without a positive microbiology and biopsy for bacterial load containment purposes, considering also the patient’s clinical and endemic epidemiology. The diagnosis was confirmed with a positive mycobacterial culture after the initiation of anti-tuberculosis therapy. In the present study, we also review the diagnosis of 20 other cases of disseminated tuberculosis reported in other countries.

Keywords: Disseminated TB, diagnosis, endemic, immunocompetent

Allen Widysanto, Audrey Suryani Soetjipto, Nata Pratama Lugito. Massive Disseminated Tuberculosis in an Immunocompetent Patient: Early Diagnostic and Empiric Treatment Approach from an Endemic Country: Indonesia (A Case Report and Literature Review). Respir Case Rep. 2019; 8(3): 86-93

Sorumlu Yazar: Allen Widysanto, Indonesia
Makale Dili: Ýngilizce
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