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mmnkompetent Bir Hastada Masif Yaygn Tberkloz: Endemik Bir lke Endonezya'dan Erken Tan ve Ampirik Tedavi Yaklam (Olgu Sunumu ve Literatr Deerlendirmesi) [Respir Case Rep]
Respir Case Rep. 2019; 8(3): 86-93 | DOI: 10.5505/respircase.2019.09825

mmnkompetent Bir Hastada Masif Yaygn Tberkloz: Endemik Bir lke Endonezya'dan Erken Tan ve Ampirik Tedavi Yaklam (Olgu Sunumu ve Literatr Deerlendirmesi)

Allen Widysanto1, Audrey Suryani Soetjipto2, Nata Pratama Lugito3
1Siloam Lippo Village Karawaci, Pelita Harapan niversitesi, Gs Hastalklar Blm, Tangerang, Endonezya
2Pelita Harapan niversitesi, Pratisyen Hekim, Tangerang, Endonezya
3Siloam Lippo Village Karawaci, Pelita Harapan niversitesi, Hastalklar Klinii, Tangerang, Endonezya

Tberkloz (TB), yzyllardr bu hastal yenmek iin verilen abalara ramen hala yaygndr. Endonezya, salk hizmetlerine; zellikle de yksek derecede duyarl ve spesifik molekler aratrmaya eriime eit olmayan bir dalmyla, dnyadaki toplam TB yknn en yksek olduu nc lkedir. Enfeksiyonun kontrol altna alnmas iin hzl ve doru TB tans ok nemlidir. ARB smear testi (balgam yayma), kolayca eriilebilir ve uygun maliyetli bir testtir. Ancak, baz eksiklikleri vardr. Akcier, perikardiyal, peritoneal, utero-over, genitoriner ve dalak tutulumu ile ikinci basamak bir salk tesisine bavuran, ncesinde salkl 23 yandaki Endonezyal bir kadnda, ARB yayma negatif dissemine tberkloz (TB) saptadmz olguyu sunuyoruz. Klinisyen, hastann klinii ve hastaln endemik epidemiyolojisini gz nne alarak, pozitif mikrobiyoloji ve tansal biyopsi sonucu olmadan anti-tberkloz tedavisine balamay tercih etti. Anti-tberkloz tedavinin balanmasndan 2 ay sonra ortaya kan pozitif mikobakteriyel kltr ile tan doruland. Ayrca, dier lkelerden bildirilen 20 adet immnokompetan dissemine tberklozular da inceledik.

Anahtar Kelimeler: yaygn tberkloz, tan, endemik, immnkompetent

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 patients 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
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