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ERRI PRATAMA
405140008
KEY FACTS
Tuberculosis (TB) is a top infectious disease killer worldwide.
In 2014, 9.6 million people fell ill with TB and 1.5 million died from the
disease.
Over 95% of TB deaths occur in low- and middle-income countries, and it is among
the top 5 causes of death for women aged 15 to 44.
In 2014, an estimated 1 million children became ill with TB and 140 000 children
died of TB.
TB is a leading killer of HIV-positive people: in 2015, 1 in 3HIV deaths was
due to TB.
Globally in 2014, an estimated 480 000 people developed multidrug-resistant TB
(MDR-TB).
http://www.who.int/mediacentre/factsheets/fs104/en/
?
TUBERCULOSIS
Tuberculosis, or TB, is an infectious bacterial disease caused
by Mycobacterium tuberculosis, which most commonly affects
the lungs. It is transmitted from person to person via droplets from
the throat and lungs of people with the active respiratory disease.
http://www.who.int/topics/tuberculosis/en/
http://www.who.int/tb/publications/global_report/high_tb_burdencountrylists2016-2020summary.pdf?ua=1
LYMPH-NODE
PULMONARY
PLEURAL TB
GENITOURINARY
EXTRAPULMONAL SKELETAL
MENINGITIS TB
HIV-ASSOCIATED TB
GI TB
MDR TB PERICARD TB
MILIARY/DISSEMINATED
Dolin, Gerald L. Mandell, John E. Bennett, Raphael (2010). Mandell, Douglas, and Bennett's principles and practice of infectious diseases (7th ed.).
Philadelphia, PA: Churchill Livingstone/Elsevier. pp. Chapter 250.
Photo by: Maxim Dondyuk (Ukrainian Photographer)
Photo by: Maxim Dondyuk (Ukrainian Photographer)
Photo by: Maxim Dondyuk (Ukrainian Photographer)
Photo by: Maxim Dondyuk (Ukrainian Photographer)
Photo by: Maxim Dondyuk (Ukrainian Photographer)
Etiology:
The main cause of TB is Mycobacterium
tuberculosis, a small, aerobic, non motile
bacillus. The high lipid content of this pathogen
accounts for many of its unique clinical
characteristics. It divides every 16 to 20 hours,
which is an extremely slow rate compared with
other bacteria, which usually divide in less than an
hour.
http://textbookofbacteriology.net/MTBCDC.jpg
Gerald L. Mandell, John E. Bennett, Raphael (2010). Mandell, Douglas, and Bennett's principles and practice of infectious diseases (7th ed.). Philadelphia, PA: Churchill
Livingstone/Elsevier. pp. Chapter 250
RISK FACTORS
http://www.cdc.gov/tb/topic/basics/risk.htm
Persons with Medical Conditions that Weaken the Immune System
Babies and young children often have weak immune systems. Other people can have weak immune systems, too,
especially people with any of these conditions:
• HIV infection (the virus that causes AIDS)
• Substance abuse
• Silicosis
• Diabetes mellitus
• Severe kidney disease
• Low body weight
• Organ transplants
• Head and neck cancer
• Medical treatments such as corticosteroids or organ transplant
• Specialized treatment for rheumatoid arthritis or Crohn’s disease
http://www.cdc.gov/tb/topic/basics/risk.htm
Mode of Transmission
When people with active pulmonary TB cough, sneeze, speak, sing, or spit, they expel infectious aerosol droplets
0.5 to 5.0 µm in diameter. A single sneeze can release up to 40,000 droplets. Each one of these droplets may
transmit the disease, since the infectious dose of tuberculosis is very small (the inhalation of fewer than 10
bacteria may cause an infection).
Cole E, Cook C (1998). "Characterization of infectious aerosols in health care facilities: an aid to effective engineering controls and preventive strategies". Am J
Infect Control 26 (4): 453–64.
HOW TO DIAGNOSE A TB PATIENT?
SPUTUM CULTURES
Ziehl – Neelsen Staining
CXR
In active pulmonary TB, infiltrates or
consolidations and/or cavities are often seen
in the upper lungs with or without
mediastinal or hilar lymphadenopathy or
pleural effusions ( tuberculous pleurisy).
http://img.medscapestatic.com/pi/meds/ckb/20/37520tn.jpg
Immunological test
ALS Assay
Transdermal Patch
Tuberculin skin test
Adenosine deaminase
http://www.cdc.gov/tb/?404;http://www.cdc.gov:80/tb/pubs/
Mantoux/part1.htm
Treatment
• Kemoterapi
• Pada kasus NSCLC stadium lanjut, kemoterapi merupakan
pilihan terapi pertama.
• Kemoterapi dapat diberikan dengan atau tanpa radioterapi,
sesuai kebutuhan pasien.
• Kemoterapi biasanya diberikan dalam bentuk kombinasi dua
obat.
• Meliputi empat kombinasi dasar platinum yaitu
cisplatin/paclitaxel, gemcitabine/cisplatin,
cisplatin/docetaxel dan carboplatin/paclitaxel.
• Jika pasien tidak memberikan respon terhadap terapi lini
pertama atau kanker muncul kembali, maka terapi lini kedua
harus diberikan. Kemoterapi lini kedua yang umum
digunakan adalah docetaxel dan pemetrexed dan navelbine