2023-12-18 03:03:35
Dr. Manun raised the case of a patient with pulmonary tuberculosis. Allergic to hepatitis medicine
December 18, 2023 at 10:03 a.m.
Dr. Manun raised the case of a patient with pulmonary tuberculosis. Allergic reaction to medicine causing hepatitis Reminder that pulmonary tuberculosis is still a common problem in Thailand. Some people take medicine and become allergic. Need to adjust medication formula This disease can be cured. Always observe symptoms of cough, low fever, loss of appetite, weight loss of 12 kg within 1 month, tuberculosis. Today (18 Dec. 2023) Dr. Manoon Leechawengwong, a physician specializing in respiratory diseases and intensive care patients. Take the case of a 69-year-old male patient who came to see the doctor with low-grade fever in the followingnoon, coughing up white sputum without blood, fatigue, loss of appetite, and weight loss of 12 kilograms within 1 month. The patient gave a history of having high blood pressure and having smoked. Cigarettes, but stopped smoking for 45 years. No one in the house was sick with tuberculosis. “Physical examination results Listen to lung sounds and find abnormalities. When the lungs are x-rayed, there are white patches on both sides. The doctor therefore ordered the sputum to be collected and sent for staining and found TB 1+. The genetic code was examined and found TB bacteria that was not resistant to rifampicin. Cultures showed tuberculosis that was sensitive to isoniazid, rifampicin, and ethambutol. It was concluded that the patient had non-drug-resistant pulmonary tuberculosis. Isoniazid, rifampicin, pyrazinamide were started. and ethambutol After taking tuberculosis medicine for 2 weeks, the patient had nausea, vomiting, loss of appetite, elevated liver enzymes SGOT 312, SGPT 199. The doctor suspected that an allergy to rifampicin had caused hepatitis. Therefore, rifampicin was stopped. Administer moxifloxacin. (Moxifloxacin) instead of rifampicin Liver enzyme values decreased: SGOT 57, SGPT 36,” Dr. Manoon stated. In this case, the doctor treated him with isoniazid tuberculosis medicine. Pirazinamide, Ethambutol and Moxifloxacin, continued for 1 year, no coughing, no appetite, weight gain 14 kilograms, lung x-ray results greatly improved. After stopping taking the medicine for 4 years, the tuberculosis did not return. The lung X-ray still has some traces of old tuberculosis. Dr. Manun reminds that pulmonary tuberculosis is still a common problem in Thailand. Some people take medicine and become allergic. The medication regimen must be adjusted. However, tuberculosis can be cured.
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