Tuberculosis, also known as TB, is a deadly infectious disease that is caused by

mycobacteria. This disease usually kills more than 50% of its victims, but early
diagnosis and treatment can help reduce the risk of worsening of the disease. Some
of the early tuberculosis symptoms are mentioned below:
1. Chronic cough with blood-tinged sputum is one of the classic symptoms
of tuberculosis. Cough is characterized by a sudden and repetitively occurring
reflex that is generally caused by foreign particles and irritants, in this case, the
mycobacteria. This release of air causes the infection to spread to anyone in close
physical proximity. Chest pain may occur simultaneously with chronic cough.
2. Fever is a common tuberculosis sign and symptom and also induces other
symptoms such as shivering.
3. Night sweats are a sign of tuberculosis and can be seen in patients of any
age.
4. Weight loss due to tuberculosis is a very distinct characteristic of
pulmonary tuberculosis. People with TB may also feel fatigued.
5. Appetite loss is also another symptom of tuberculosis and leads to further
degradation of health and immune system.
http://www.newsmax.com/FastFeatures/tuberculosis-symptoms-signs-
treatment/2010/11/10/id/371491

Faktor resiko TB

Some people are more likely than others to get TB. This includes people who:
Have HIV or another illness that weakens the immune system.
Have close contact with someone who has active TB, such as living in the same house as
someone who is infected with TB.

Care for a patient who has active TB, such as doctors or nurses.

Live or work in crowded places, such as prisons, nursing homes, or homeless shelters, where
other people may have active TB.

Have poor access to health care, such as homeless people and migrant farm workers.

Abuse drugs or alcohol.

Travel to or were born in places where untreated TB is common, such as Latin America,
Africa, Asia, Eastern Europe, and Russia.

The goal of treatment is to cure the infection with drugs that fight the TB bacteria. Treatment of active
pulmonary TB will always involve a combination of many drugs (usually four drugs). All of the drugs
are continued until lab tests show which medicines work best.

Kategori 1 ( 2 HRZE/ 4H3R3), TB baru,BTA positif; TB paru BTA negatif foto toraks +; TB ekstra paru

Tahap intensif maupun lanjutan, intensif 56 hari RHZE dan lanjutan 3x seminggu 16 minggu RH

Kategori 2 ( 2HRZES/HRZE/ 5H3R3E3 ) pasien BTA positif (kambuh,gagal, putus berobat) biasa putus
berobat setelah gejala hilang, kambuh biasanya lebih parah.
 Tahap intensif tiap hari HRZE = Streptomycin dan lanjutan 3x seminggu RH + E. Streptomycin masuk
aminoglikosid ototoksik, pulang diberi surat pengantar suntik boka boki dengan peringatan bila
ada gangguan pendengaran lapor ke dokter terdekat. Tidak boleh pada saat kehamilan.

OAT sisipan : setelah pengobatan intensif bila BTA masih +, diberi OAT sisipan 28 hari.

Commonly used drugs include:

Isoniazid
Rifampin

Pyrazinamide

Ethambutol

Other drugs that may be used to treat TB include:

Amikacin
Ethionamide

Moxifloxacin

Para-aminosalicylic acid

Streptomycin

You may need to take many different pills at different times of the day for 6 months or longer. It is very
important that you take the pills the way your health care provider instructed.

When people do not take their TB medications as instructed, the infection can become much more
difficult to treat. The TB bacteria can become resistant to treatment. This means the drugs no longer
work.

When there is a concern that a patient may not take all the medication as directed, a health care
provider may need to watch the person take the prescribed drugs. This approach is called directly
observed therapy. In this case, drugs may be given 2 or 3 times per week, as prescribed by a doctor.

You may need to stay at home or be admitted to a hospital for 2 - 4 weeks to avoid spreading the
disease to others until you are no longer contagious.

Your doctor or nurse is required by law to report your TB illness to the local health department. Your
health care team will be sure that you receive the best care.

Lung Diseases Affecting the Airways

The trachea (windpipe) branches into tubes called bronchi, which in turn branch to become
progressively smaller tubes throughout the lungs. Diseases that affect the airways include:
Asthma: The airways are persistently inflamed, and may occasionally spasm, causing
wheezing and shortness of breath.Allergies, infections, or pollution can trigger asthma's symptoms.
 Chronic obstructive pulmonary disease (COPD): Lung conditions defined by an inability to
exhale normally, which causes difficulty breathing.

Chronic bronchitis: A form of COPD characterized by a chronic productivecough.

Emphysema: Lung damage allows air to be trapped in the lungs in this form of COPD.
Difficulty blowing air out is its hallmark.

Acute bronchitis: A sudden infection of the airways, usually by a virus.

Cystic fibrosis: A genetic condition causing poor clearance of mucus from the bronchi. The
accumulated mucus results in repeated lung infections.

Lung Diseases Affecting the Air Sacs (Alveoli)

The airways eventually branch into tiny tubes (bronchioles) that dead-end into clusters of air sacs
called alveoli. These air sacs make up most of the lung tissue. Lung diseases affecting the alveoli
include:
Pneumonia: An infection of the alveoli, usually by bacteria.
Tuberculosis: A slowly progressive pneumonia caused by the bacteriaMycobacterium
tuberculosis.

Emphysema results from damage to the fragile connections between alveoli. Smoking is the
usual cause. (Emphysema also limits airflow, affecting the airways as well.)

Pulmonary edema: Fluid leaks out of the small blood vessels of the lung into the air sacs and
the surrounding area. One form is caused by heart failure and back pressure in the lungs' blood
vessels; in another form, direct injury to the lung causes the leak of fluid.

Lung cancer has many forms, and may develop in any part of the lungs. Most often this is in
the main part of the lung, in or near the air sacs. The type, location, and spread of
lung cancer determines the treatment options.

Acute respiratory distress syndrome (ARDS): Severe, sudden injury to the lungs caused by a
serious illness. Life support with mechanical ventilation is usually needed to survive until the lungs
recover.

Pneumoconiosis: A category of conditions caused by the inhalation of a substance that injures

the lungs. Examples include black lung disease from inhaled coal dust and asbestosis from inhaled
asbestos dust.

Lung Diseases Affecting the Interstitium

The interstitium is the microscopically thin, delicate lining between the lungs' air sacs (alveoli). Tiny
blood vessels run through the interstitium and allow gas exchange between the alveoli and the blood.
Various lung diseases affect the interstitium:
Interstitial lung disease (ILD): A broad collection of lung conditions affecting the
interstitium. Sarcoidosis, idiopathic pulmonary fibrosis, and autoimmune diseaseare among the many
types of ILD.
Pneumonias and pulmonary edemas can also affect the interstitium.

Lung Diseases Affecting Blood Vessels

 The right side of the heart receives low-oxygen blood from the veins. It pumps blood into the lungs
through the pulmonary arteries. These blood vessels can suffer from disease, as well.
Pulmonary embolism (PE): A blood clot (usually in a deep leg vein, deep vein thrombosis)
breaks off, travels to the heart, and is pumped into the lungs. The clot lodges in a pulmonary artery,
often causing shortness of breath and low blood oxygen levels.
Pulmonary hypertension: Various conditions can lead to high blood pressure in the pulmonary
arteries. This can cause shortness of breath and chest pain. When no cause is identified, the
condition is called idiopathic pulmonary arterial hypertension.

Lung Diseases Affecting the Pleura

The pleura is a thin lining that surrounds the lung and lines the inside of the chest wall. A tiny layer of
fluid allows the pleura on the lung's surface to slide along the chest wall with each breath. Lung
diseases of the pleura include:
Pleural effusion: Fluid collects in the normally tiny pleura space between the lung and the
chest wall. Pneumonia or heart failure is usually responsible. If large, pleural effusions can impair
breathing, and should be drained.
Pneumothorax: Air may enter the space between the chest wall and the lung, collapsing the
lung. To remove the air, a tube is typically inserted through the chest wall.

Mesothelioma: A rare form of cancer that forms on the pleura. Mesothelioma tends to emerge
several decades after asbestos exposure.

Lung Diseases Affecting the Chest Wall

The chest wall also plays an important role in breathing. Muscles connect the ribs to each other,
helping the chest to expand. The diaphragm descends with each breath in, also causing chest
expansion.
Obesity hypoventilation syndrome: Extra weight on the chest and abdomen makes it difficult
for the chest to expand. Serious breathing problems can result.
Neuromuscular disorders: Poor function in the nerves controlling the respiratory muscles
causes difficulty breathing. Amyotrophic lateral sclerosis and myasthenia gravis are examples of
neuromuscular lung disease

Suara paru abnormal :

Rales are small clicking, bubbling, or rattling sounds in the lungs. They are believed to occur when air
opens closed air spaces. Rales can be further described as moist, dry, fine, and course.

Rhonchi are sounds that resemble snoring. They occur when air is blocked or becomes rough through
the large airways.

Wheezes are high-pitched sounds produced by narrowed airways. They can be heard when a person
breathes out (exhales). Wheezing and other abnormal sounds can sometimes be heard without a
stethoscope.

Stridor is a wheeze-like sound heard when a person breathes. Usually it is due to a blockage of
airflow in the windpipe (trachea) or in the back of the throat.
Pleural rubs are discontinuous or continuous, creaking or grating sounds. The
sound has been described as similar to walking on fresh snow or a leather-on-
leather type of sound. Coughing will not alter the sound. They are produced
because two inflamed surfaces are sliding by one another, such as in pleurisy.

During auscultation, pleural rubs can usually be localized to a particular place on

the chest wall. They also come and go.

Because these sounds occur whenever the patient's chest wall moves, they
appear on inspiration and expiration. Pleural rubs stop when the patient holds
her breath. If the rubbing sound continues while the patient holds a breath, it
may be a pericardial friction rub.

Inspiration to expiration periods are equal with bronchovesicular lung sounds.

These are normal sounds in the mid-chest area or in the posterior chest between
the scapula. They reflect a mixture of the pitch of the bronchial breath sounds
heard near the trachea and the alveoli with the vesicular sound. They have an
I:E ratio of 1:1.