Persons who have tb disease are usually infectious and may spread the bacteria to other people. Tuberculous meningitis is mycobacterium tuberculosis infection of the meningesthe system of membranes which envelop the central nervous system. Localized infection escalates within the lungs, with dissemination to the regional lymph nodes. Dec 21, 2011 tuberculous meningitis tbm is the most common form of central nervous system tuberculosis tb and has very high morbidity and mortality.
In general, meningitis caused by a virus is less serious than meningitis caused by bacteria. Morbiditas dan mortalitas penyakit ini tinggi dan prognosisnya buruk. Extrapulmonary tb disease should be considered in the differential diagnosis of ill persons who have systemic symptoms and who are at high risk for tb disease. Untuk kasus tb tertentu yaitu tb milier, efusi pleura tb, perikarditis tb, tb endobronkial, meningitis tb dan peritonitis tb diberikan kortikosteroid prednison dengan dosis 12 mgkg bbhari, dibagi dalam 3 dosis. It is not known why one person gets meningitis when others exposed to the same germs do not get as sick, or dont get sick at all. Latar belakang definisi tuberkulosis tb ekstraparu adalah infeksi tb yang menyerang organ selain paru seperti pleura, kelenjar getah bening, gastrointestinal, traktus genitourinarius, kulit, tulang, sendi dan selaput otak. Body fluid or tissue from the disease site should be collected for afb smear and culture see chapter 5, treatment for latent tuberculosis infection. Tb paru dapat menular melalui udara, waktu seseorang dengan tb aktif pada paru batuk, bersin atau bicara 1. The bacteria spread to the brain and spine from another place in the body, usually the lung. Data yang akan didapatkan pada pengkajian meningitis tb adalah. Konsensus baru tatalaksana tuberkulosis ekstraparu c.
Beberapa perubahan baru seperti yang dituangkan pada buku pedoman pengobatan yang diterbitkan who juga diakomodir dengan tetap mempertimbangkan situasi spesifik program tb di indonesia, seperti perubahan teknis. Guidelines for treatment of drugsusceptible tuberculosis. Berbagai upaya untuk menentukan diagnosis tb pada anak telah dilakukan, namun sampai saat ini belum ada yang dapat mendiagnosis secara pasti selain biakan rculosis. In highly endemic areas, the risk of tb infection in contacts of tb infectious cases is associated with age, sex, intensity of exposure to the case, and severity of disease in the case, but it is. Tuberculous meningitis is also known as tb meningitis or tubercular meningitis. Belum memadainya tatalaksana tb sesuai dengan standar baik dalam penemuan. Indonesia tuberculosis profile population 2018 268 million estimates of tb burden. Konsensus baru tatalaksana tuberkulosis ekstraparu 1. Latar belakang definisi tuberkulosis tb ekstraparu adalah infeksi tb yang menyerang organ selain paru seperti pleura, kelenjar getah bening, gastrointestinal, traktus genitourinarius. Penatalaksanaan yang tepat pada meningitis tuberkulosis prompt.
Ukk unit kerja koordinasi pulmonologi idai telah membuat konsensus nasional tb anak yang telah dipakai oleh departemen kesehatan sebagai pedoman nasional program pemberantasan tb secara nasional. Tb merupakan penyebab kematian nomor tiga 3 setelah penyakit kardiovaskuler dan penyakit saluran pernafasan pada semua kelompok usia, dan nomor satu 1 dari golongan penyakit infeksi. Skoring tb pada anak idai ikatan dokter anak indonesia. We compare two established scoring systems, thwaites and the lancet consensus scoring system for the diagnosis of tb and compare the. Aug 31, 2015 pedoman nasiaonal penyakit tb 2014 slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Streptomisin diberikan secara intramuskular dengan dosis 1540 mg kgbb hari, maksimal 1 gram hari, dan kadar puncak 4550. Risk factors tb and tb meningitis can develop in children and adults of all ages. Epidemiologi tuberkulosis tb merupakan masalah kesehatan masyarakat yang. Diagnosis tb pada anak dengan sistem skoring sebaiknya ditegakkan oleh dokter. Penelitian rizkiyani pada tahun 2008 menunjukkan jumlah penderita baru tb paru positif 87,6% berasal. Klik disini untuk membaca konsep medis meningitis tb. Insiden meningitis tb sebanding dengan tb primer, umumnya bergantung pada status sosioekonomi, higiene masyarakat, umur, status gizi dan faktor genetik yang menentukan respon imun seseorang. Tuberculous meningitis tbm is the most severe form of infection caused by mycobacterium tuberculosis, causing death or disability in more than half of those affected. Tb meningitis cteodorescu free download as powerpoint presentation.
Meningeal tuberculosis is also known as tubercular meningitis or tb meningitis. You get it when a virus enters the body through the nose or mouth and travels to the brain. Tuberculous meningitis is very rare in the united states. However, tuberculosis affects populations in every country and all neurologists need to be vigilant for possible cases of tuberculous meningitis presenting to their medical facilities. The progression from ltbi to tb disease may occur at any time, from soon to many years later. Pedoman nasiaonal penyakit tb 2014 slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. The infection usually begins elsewhere in the body, usually in the lungs, and then travels through the bloodstream to the meninges where small abscesses called microtubercles are. Bayi dan balita paling beresiko terkena tb berat seperti meningitis tb yang mampu menyebabkan buta, tuli serta kelumpuhan. Tbm is typically a subacute disease with symptoms that may persist for weeks before diagnosis. Setelah usia 1 tahun dan sebelum pubertas, anak yang terinfeksi dapat terkena penyakit tuberkulosa milier atau meningitis, ataupun juga bentuk kronis lain dari infeksi tuberkulosa seperti infeksi ke nodus limfatikus, tulang atau sendi. Tuberculosis is a common cause of meningitis in developing countries with a high prevalence of pulmonary tuberculosis. Lama pemberian kortikosteroid adalah 24 minggu dengan dosis penuh dilanjutkan tappering off dalam jangka waktu 26 minggu. Tuberculous and fungal meningitis are less common in the united. Ruling out meningitisencephalitis is a big headache it is okay to go out of order for diagnostics and treatment of suspected bacterial meningitis steroids before or with antibiotics pretend to know indications for when to ct a patient asepticfungal meningitis in special populations empirically treat encephalitis with acyclovir.
Choose the one best answer and write the letter for the correct answer on the line next to the. Akhirnya dengan penerbitan buku pedoman pengendalian tuberkulosis cetakan tahun 2011, mudah mudahan dapat merespon usulan, terutama dari pengguna baik. Tuberkulosis endobronkial lesi segmental yang timbul akibat pembesaran kelenjar regional dapat terjadi dalam waktu yang lebih lama 39 bulan. A read is counted each time someone views a publication summary such as the title, abstract, and list of authors, clicks on a figure, or views or downloads the fulltext. Tuberculous meningitis tbm is a major clinical and public health problem, both for diagnosis and management. Pdf pedoman penatalaksanaan tb konsensus tb elisabeth.
Tuberculous tb meningitis occurs when tuberculosis bacteria myobacterium tuberculosis invade the membranes and fluid surrounding the brain and spinal cord. The most common symptoms are fever, headache, and neck stiffness. Other symptoms include confusion or altered consciousness, vomiting, and an inability to tolerate light or loud noises. Dec 07, 2017 tuberculous meningitis tbm develops in 2 steps. Sekitar 95% kasus tb dan 98% kematian akibat tb di dunia terjadi di negara berkembang. Jika diagnosis belum jelas, pengobatan empiris untuk meningitis tb dapat. Pada tahun 1992 world health organization who telah mencanangkan tuberkulosis sebagai global emergency laporan who tahun 2004. Young children and people living with hiv continue to be at highest risk for tb meningitis. Characteristic cerebrospinal fluid csf findings of tbm include a lymphocyticpredominant pleiocytosis, elevated protein, and low glucose. If you continue browsing the site, you agree to the use of cookies on this website. The who guidelines for treatment of drugsusceptible tuberculosis and patient care 2017 update contains policy recommendations on priority areas in the treatment of drugsusceptible tb and patient care. Centers for disease control cdc melaporkan pada tahun 1990 morbiditas meningitis tb 6,2% dari seluruh kasus tb ekstrapulmonal. Dexamethasone for the treatment of tuberculous meningitis. The most lethal and disabling form of tuberculosis is tuberculous meningitis tbm, for which more than 100,000 new cases are estimated to occur per year.
This is normally caused by infection but can also have non. Meningitis tb, nyeri dada pada tb pleura pleuritis, pembesaran kelenjar limfe. Sometimes funguses, cancers, head injuries or other factors can cause meningitis, but cases from these sources are rare. Tuberculous meningitis g thwaites, t t h chau, n t h mai, f drobniewski, k mcadam, j farrar uncertainty and doubt dominate all aspects of tuberculous meningitis tbm. Tuberculous meningitis is caused by mycobacterium tuberculosis. Meningitis tb, bentuk serangan tbc yang paling berbahaya. Mycobacterium tuberculosis dari infeksi primer pada paru 5.
Tb meningitis tuberculous meningitis can display symptoms such as aches and pains, loss of appetite and tiredness, with a persistent headache, there are around 150 200 cases of tb meningitis reported each year in the uk. Saat ini streptomisin jarang digunakan dalam pengobatan tuberkulosis, tetapi penggunaannya penting pada pengobatan fase intensif meningitis tuberkulosis dan mdr tb multi drug resistent tuberculosis. Tb paru menyerang siapa saja tua, muda bahkan anakanak. Memahami dan melakukan tatalaksana penyakit tuberkulosis pada anak. Tb terutama menyerang paru, tapi 2030% tb pada anak menyerang organ lain. Sep 11, 2017 as the most severe form of tuberculosis tb, tb meningitis disproportionately affects developing countries and results in significant morbidity and mortality. Characteristic cerebrospinal fluid csf findings of tbm include. Meningitis tuberkulosis merupakan salah satu bentuk meningitis disebabkan oleh bakteri mycobacterium tuberkulosa yang menyebar ke otak dari bagian tubuh yang lain. Hasil survey prevalensi tb di indonesia tahun 2004 menunjukkan bahwa angka prevalensi tb bta positif secara nasional 110 per 100. The who guidelines for treatment of drugsusceptible tuberculosis and patient care 2017 update contains policy recommendations on priority areas in the treatment of drugsusceptible tb. Meningitis occurs when the membranes that cover the brain and spinal cord become inflamed. Tuberculosis tb meningitis meningitis research foundation. A definite diagnosis of tbm is made if there is evidence of acid fast bacilli.
Tuberculous meningitis tbm is the most common form of central nervous system tuberculosis tb and has very high morbidity and mortality. Ada banyak jenis penyakit meningitis salah satunya adalah meningitis tb yang disebabkan oleh bakteri mycobacterium tuberculosis. Sakit kepala dan demam adalah gejala awal yang sering. Tb paru ini bersifat menahun dan secara khas ditandai oleh pembentukan granuloma dan menimbulkan nekrosis jaringan. Secara global diperkirakan insidens tb resisten obat adalah 3,7% kasus baru dan 20% kasus dengan riwayat pengobatan. Ziehlneelsen staining lacks sensitivity and culture. Tuberculous meningitis tbm can occur as the sole manifestation of tb or concurrent with pulmonary or other extrapulmonary sites of infection. Guidelines for treatment of drugsusceptible tuberculosis and. Diagnosis, initial management, and prevention of meningitis.
Tuberculous meningitis tbm is a chronic infection of the meninges caused by mycobacterium tuberculosis. Askep meningitis tb lanjutan dari konsep medis meningitis tb. Bila terjadi epidemi meningitis meningokokal, nasihati keluarga untuk kemungkinan adanya kasus susulan pada anggota keluarga lainnya sehingga mereka dapat melaporkan dengan segera bila hal tersebut ditemukan. Meningitis is inflammation of the thin tissue that surrounds the brain and spinal cord, called the meninges. Tbm is typically a subacute disease with symptoms that. Mycobacterium tuberculosis bacilli enter the host by droplet inhalation. Epidemiologi tuberkulosis tb merupakan masalah kesehatan masyarakat yang penting di dunia ini. Epidemiology india has one fifth of the worlds tb burden. Apr 15, 2015 foto toraks bukan merupakan alat diagnostik utama pada tb anak. Pathogenesis dissemination of bacilli to the meninges and brain occurs as a complication of the primary infection, or as a complication of an existing tb lesion tuberculoma, miliary tb or reactivation of a latent tb focus.
Chapter 2 transmission and pathogenesis of tuberculosis. Ukk unit kerja koordinasi pulmonologi idai telah membuat konsensus nasional tb anak yang telah dipakai oleh departemen kesehatan sebagai pedoman nasional. Komplikasi meningitis tb terjadi setiap 300 kasus tb primer yang tidak diobati. Meningitis is an acute inflammation of the protective membranes covering the brain and spinal cord, known collectively as the meninges. Sebagian besar penderita tb paru di negara berkembang berumur dibawah 50 tahun. The peripheral white blood cell count alone is not help. Tuberculous meningitis is the severest form of infection with mycobacterium tuberculosis, causing death or severe neurologic deficits in more than half of those affected in spite of antituberculosi.
Meningitis tuberkulosis merupakan hasil dari penyebaran hematogen dan limfogen bakteri. Indonesia tuberculosis profile world health organization. Meningitis tb merupakan salah satu komplikasi tb primer. Dec 07, 2017 tuberculous meningitis tbm is difficult to diagnose, and a high index of suspicion is needed to make an early diagnosis. Apabila di fasilitas pelayanan kesehatan tidak ada dokter, pelimpahan wewenang terbatas dapat diberikan kepada petugas kesehatan lainnya. Meningitis tb lapkas anak free download as powerpoint presentation. Inquire about the patients medical and social history, including recent contact with patients with tuberculosis tb. The variable natural history and accompanying clinical features of tbm hinders the diagnosis. Delay in diagnosis and treatment hiv, immunocompromised state. Data who menunjukkan bahwa kasus tb paru di negara berkembang banyak terdapat pada umur produktif 1529 tahun. Clinical and public health aspects of tb meningitis in children.