Académique Documents
Professionnel Documents
Culture Documents
INTRODUCTION
1.1. Background
Tuberculosis sufferers in the Asian region continue to grow. So far, Asia is one of the regions
with the highest spread of tuberculosis (TB) in the world. Every 30 seconds, one patient in Asia
dies from this disease. Eleven of the 22 countries with the highest TB cases are in Asia,
including Bangladesh, China, India, Indonesia and Pakistan. Four out of five TB sufferers in
Asia include the productive age group (Kompas, 2007). In Indonesia, the mortality rate due to
TB reaches 140,000 people per year or 8 percent of deaths worldwide. Every year, there are
more than 500,000 new cases of TB, and 75 percent of sufferers belong to the productive age
group. The number of TB sufferers in Indonesia is the third largest in the world after India and
China.
1.2. Problem
1. What is the Definition of TB?
2. Why can someone get Pulmonary TB?
3. What are the signs and symptoms of pulmonary TB?
1.3. Purpose
1. To explain the definition of pulmonary tuberculosis
2. To explain the causes of pulmonary TB disease, the signs and symptoms and the
pathophysiology in the body.
1.4. Benefit
1. To find out the definition of pulmonary TB.
2. To find out the causes of pulmonary TB disease, the signs and symptoms and the
pathophysiology in the body.
CHAPTER II
EXPLAINING
2.1. Definition
2.2. Signs
a. Weight loss
b. Anorexia
c. Dispneu
d. Sputum Purulent/green, mucoid/yellow.
2.3. Symptoms
a) Fever
Usually resembles influenza fever. This situation is strongly influenced by the body's
resistance to the severity of infection of the incoming TB germs.
b) Cough
Occurs because of an infection in the bronchi. The nature of cough starts from a dry
cough then after inflammation develops into a productive cough (produces sputum). In
a state of advanced form coughing up blood because there are broken blood vessels.
Most coughing up blood on bronchial wall ulcers.
c) Out of breath.
Shortness of breath will be found in advanced disease where the infiltration is half the
lung
d) Chest pain
Arises when inflammation infiltration has reached the pleura (causing pleurisy)
e) Malaise
Can be anorexia, no appetite, weight loss, headaches, chills, muscle aches, night sweats
2.4. Pathophysiology
In tuberculosis, tuberculosis bacilli cause a strange tissue reaction in the lungs including:
invasion of the infected area by macrophages, formation of a wall around the lesion by fibrous
tissue to form what is called a tubercle. The large number of fibrosis areas causes increased
respiratory muscle effort for pulmonary ventilation and therefore decreases vital capacity,
decreases the total surface area of the respiratory membrane which causes a progressive
decrease in pulmonary diffusion capacity, and an abnormal ventilation-perfusion ratio in the
lungs can reduce blood oxygenation.
2.7. Complications
Complications of pulmonary TB disease if not treated properly will cause complications such
as: pleurisy, pleural effusion, empyema, laryngitis, intestinal TB. According to Dep. Kes
(2003) complications that often occur in patients with advanced pulmonary TB: 1) Severe
hemoptysis (bleeding from the lower respiratory tract) which can result in death due to
hypovolemic shock or airway obstruction. 2) Collapses from the lobes due to bronchial
retraction. 3) Bronchiectasis and fribosis in the Lungs. 4) Spontaneous pneumothorax:
spontaneous collapse due to damage to Lung tissue. 5) The spread of infection to other organs
such as the brain, bones, joints, kidneys and so on. 6) Cardio Pulmonary Insufficiency.
2.8. Handling
a. Promotive
1. Counseling to the community what is TB
2. Good notification through banners / advertisements about the dangers of tuberculosis,
modes of transmission, ways of prevention, risk factors
3. Socializing BCG programs in the community.
b. Preventive
1. BCG vaccination
2. Using isoniazid (INH)
3. Clean the environment from a dirty and humid place.
4. If there are TB symptoms immediately to the health center / hospital, so they can be known
early.
c. Curative
Treatment of tuberculosis, especially in the long term administration of antimicrobial drugs.
Medications can also be used to prevent the onset of clinical disease in someone who has
contracted the infection. Patients with tuberculosis with clinical symptoms should receive two
drugs to prevent the emergence of drug-resistant strains.
The combination of selected drugs is isoniazid (isonicyckotic acid hydrazide = INH) with
ethambutol (EMB) or rifamsipin (RIF). The usual dose of INH for adults is usually 5-10 mg /
kg or about 300 mg / day, EMB, 25 mg / kg for 60 days, then 15 mg / kg, RIF 600 mg once
daily. Ethambutol side effects are retrobulbar neuritis with a decrease in visual acuity. A visual
acuity test is recommended every month for this to be known. Severe INH side effects are rare.
The most severe complication is hepatitis. The risk of hepatitis is very low in patients under
the age of 20 years and reaches its peak at the age of 60 years and over. Liver dysfunction, as
evidenced by an increase in serum aminotransferase activity, was found in 10-20% who
received INH. Minimum time of combination therapy 18 months after conversion of sputum
culture to negative. After that, therapy with INH should only be recommended for one year.
Recently the CDC and American Thoracis Societty (ATS) issued a statement regarding the
recommendations of short-term chemotherapy for tuberculosis patients with a history of 6 or 9
months of pulmonary tuberculosis related to a regimen consisting of INH and RIF (without or
with other drugs), and only given to uncomplicated pulmonary tuberculosis patients, for
example: patients without other diseases such as diabetes, silicosis or cancer are diagnosed
with tuberculosis after coughing up blood, even though they experience stones and sweat about
3 weeks.
CHAPTER III
CONCLUSSION
3.1 Conclusions