Miliary Pulmonary TB with Oral Thrush et causa HIV; Case Report

Authors

  • Hariz Ghulam Ramadhan Universitas Lampung
  • Lucky Togihon Bagian Kedokteran Paru dan Respirasi, RSUD DR. H. Abdoel Moeloek Bandar Lampung

DOI:

https://doi.org/10.53089/medula.v13i3.559

Keywords:

Antiretrovirals, Human immunodeficiency virus (HIV), Fixed Drug Combination (FDC), Tuberculosis

Abstract

Tuberculosis (TB) is a leading cause of morbidity and mortality among HIV-infected patients while HIV remains one of risk factor for the development of active TB infection. In infected individuals, Mycobacterium tuberculosis and HIV accelerate the decline in immunological function. Treatment integration is a key in reducing mortality in patients with HIV-TB co-infection. This case report discusses a 22-year-old male patient who experienced chronic cough, chronic dyspnea, intermittent fever, malaise, night sweats, decreased appetite and weight loss. The patient has a history of free sex and a history of pulmonary tuberculosis in his mother. The results of the physical examination, a white membrane was found on the cheek mucosa and on the surface of the patient's tongue indicating the presence of oral thrush and there were coarse wet crackles in both lung fields of the patient. From the results of supporting examinations, a chest X-ray impression of miliary pulmonary TB, GeneXpert MTB/rifampicin sputum results, positive MTB with sensitivity to rifampicin, and reactive Anti-HIV results. So that from the results of the history, physical examination, and supporting examinations in this patient, the diagnosis is miliary pulmonary TB with oral thrush et causa HIV. This patient was given pharmacological treatment 4 Fixed Drug Combination (FDC) 2 tablets/day, N-Acetylcysteine 200 mg 3 times a day, Co-trimoxazole 960 mg 1 time a day and vit B6 25 mg 1 time a day. Antiretroviral therapy (ARV) can given in 2- 8 weeks after OAT therapy. Monitoring was carried out after 2,5, and 6 months of treatment through the results of sputum smear examination and chest X-ray. The most important side effect that needs to be evaluated in patients is Immune Reconstitution Inflammatory Syndrome (IRIS).The patients had good vital signs and reasonable OAT side effects.

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Published

2023-02-25

How to Cite

Ramadhan, H. G. ., & Togihon , L. . (2023). Miliary Pulmonary TB with Oral Thrush et causa HIV; Case Report. Medical Profession Journal of Lampung, 13(3), 277-285. https://doi.org/10.53089/medula.v13i3.559

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