REFERAT TB

RADIOLOGI

Epidemiologi

• Mycobacterium tuberculosis telah menginfeksi sepertiga penduduk dunia.

• TBC menjadi penyebab kematian utama, hingga dua juta orang pada tahun 1990. Hal tersebut disebabkan oleh : (1) program pengendalian penyakit yang tidak adekuat. (2) Multiple Drug Resistance (MDR). (3) co-infection dengan HIV. (4) Peningkatan jumlah penduduk, terutama dewasa muda yang merupakan kelompok umur dengan mortalitas tertinggi dari tuberkulosis.

• Berdasarkan Global Tuberculosis Control Tahun 2009 (data tahun 2007) prevalensi semua tipe TB sebesar 244 per 100.000 penduduk atau sekitar 565.614 kasus semua tipe TB

• insidensi semua tipe TB sebesar 228 per 100.000 penduduk atau sekitar 528.063 kasus semua tipe TB

• Insidensi kasus baru TB BTA Positif sebesar 102 per 100.000 penduduk atau sekitar 236.029 kasus baru TB Paru BTA Positif

• kematian TB 39 per 100.000 penduduk atau 250 orang per hari.

Definisi

• Tuberkulosis paru (TB) adalah suatu penyakit menular yang disebabkan oleh basil Mycobacterium tuberculosis

Klasifikasi

Paru Ekstra paru

BTA + BTA -

Organ Pengobatan

Ringan

Berat

PATOGENESIS

Primer Post Primer

Diagnosis

Klinis

Bakteriologis

Radiologis

Chest x ray (posterior–anterior) view showing significant findings.

Bansal M et al. BMJ Case Reports 2009;2009:bcr.04.2009.1823

©2009 by BMJ Publishing Group Ltd

Sputum culture-positive TB in an 82-year-old Asian woman.

Leung A N Radiology 1999;210:307-322

©1999 by Radiological Society of North America

Atypical distribution of postprimary TB in a 62-year-old man.

Leung A N Radiology 1999;210:307-322

©1999 by Radiological Society of North America

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Pattern of alveolar infiltrate, acute, with confluent small ill-defined densities, and after healing.

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Chronic Bronchitis. The magnified view shows the irregular bronchovascular structures (arrow heads).

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Postprimary pattern of TB in a 54-year-old Hispanic man.

Leung A N Radiology 1999;210:307-322©1999 by Radiological Society of North America

Chest radiograph obtained in a 3-year-old Hispanic boy shows mediastinal and right hilar lymphadenopathy.

Leung A N Radiology 1999;210:307-322©1999 by Radiological Society of North America

Chest radiograph obtained in a 7-month-old Hispanic boy shows right paratracheal lymphadenopathy (straight arrow) with multilobar consolidation predominating in the right

lung.

Leung A N Radiology 1999;210:307-322©1999 by Radiological Society of North America

Chest radiograph obtained in a 4-year-old boy shows right hilar lymphadenopathy (arrow) associated with right upper lobe consolidation.

Leung A N Radiology 1999;210:307-322©1999 by Radiological Society of North America

Chest radiograph obtained in a 19-year-old woman shows a large right-sided pleural effusion (curved arrows) associated with right hilar lymphadenopathy (straight arrows).

Leung A N Radiology 1999;210:307-322©1999 by Radiological Society of North America

Atypical distribution of postprimary TB in a 62-year-old man.

Leung A N Radiology 1999;210:307-322©1999 by Radiological Society of North America

Close-up radiographic view of the upper lung zones in a 56-year-old Hispanic man shows ill-defined parenchymal opacities (white arrows) associated with nodular and linear

components in the periphery of the bilateral upper lobes.

Leung A N Radiology 1999;210:307-322©1999 by Radiological Society of North America

Postprimary pattern of TB in a 54-year-old Hispanic man.

Leung A N Radiology 1999;210:307-322©1999 by Radiological Society of North America

Postprimary pattern of TB in a 54-year-old Hispanic man.

Leung A N Radiology 1999;210:307-322©1999 by Radiological Society of North America

Penatalaksanaan

• Menyembuhkan penderita

• Mencegah kekambuhan

• Menurunkan tingkat penularan

• Mencegah kematian

OAT

• Kategori 1 (2RHZE/4R3H3)

• Kategori 2 (2RHZES/1RHZE/5H3R3E3)• Kategori 3 ( 2RHZE/4RH atau 6 RHE)

• Kategori 4 ( RHZES/ sesuai hasil uji resistensi + Obat lini 2 ( pengobatan minimal 18 bl)

• Sisipan (RHZE)

Hasil Pengobatan Tindak Lanjut

• Sembuh

• Pengobatan lengkap

• Meninggal

• Pindah

• DO

• Gagal