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15 Active TB in Immunocompromised Patients English Class
15 Active TB in Immunocompromised Patients English Class
15 Active TB in Immunocompromised Patients English Class
IMMUNOCOMPROMISED
PATIENTS
I MADE BAGIADA
Divisi Paru Bagian Penyakit Dalam FK
Unud/RSUP Sanglah
Denpasar
ACTIVE TB IN
IMMUNOCOMPROMISED PATIENTS
Has a number of challenges:
Impaired immune response
Clinically oligosymptomatic
Diagnosis is often delayed:
• Atypical presentations
• More frequent EP dissemination
Higher morbidity
Treatment is frequently complicated
2
ACTIVE TB IN
IMMUNOCOMPROMISED PATIENTS
Increased risk of active TB:
Immunosuppression-induced
reactivation of LTBI or new infections
Decreased risk of active TB:
Regular screening for evidence for LTBI
treat it
Screening and treatment prior to
transplantation or TNF-α antagonist
therapy 3
ACTIVE TB IN
IMMUNOCOMPROMISED PATIENTS
More frequent as compare with general
population
High morbidity and mortality
Risk assessment:
Integrative approach:
• Clinical finding
• Extent of immunodeficiency and
• Overall prevalence of TB
4
Active TB in HIV/AIDS
5
Purpose
1. Microscopic examination of
specimen of sputum that has been
stained by the Ziehl-Neelsen (ZN)
method a PTB suspect should
submit three sputum samples for
microscopy
2. Gen x-pert (molecular based)
Diagnostic tests, #2
Radiology
Aims of treatment
To cure the patient of TB
To prevent death from active TB or its
late effects
To prevent TB relapse
To decrease TB transmission to others
Treatment, #2