Primary Complex

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Primar Complex

Primary complex is condition where there is a lymph node enlargement in the chest which is seen on X-ray chest with some parenchymal (lung) involvement. Lymph nodes outside chest are not defined as primary complex. Ideal way to confirm the diagnosis of tuberculosis is to document ther tubercular germs either from lymph node or from sputum/secretions obtained from the lungs.

Drugs and its actions

The medication contains three different compounds (below) which act together to kill bacteria that cause tuberculosis (TB).

Rifampicin: Rifampicin is typically used to treat Mycobacterium infections, including tuberculosis and leprosy;

Isoniazid: Isoniazid is a first-line antituberculous medication used in the prevention and treatment of tuberculosis.

Pyrazinamide: Pyrazinamide is a drug used to treat tuberculosis in afflicted patients. The drug is largely bacteriostatic, but can be bacteriocidal on actively replicating tuberculosis bacteria.


Treatment

There are two stages in the treatment of tuberculosis. In the first two months after infection (the initial phase), treatment is aimed at killing as many bacteria as possible. Therefore several anti-TB drugs with different mechanisms of action are used in combination. After this time some of the medications are stopped and the others are continued for a further four months (continuation phase) to kill any remaining bacteria. Rifampicin and isoniazid are used in both stages of treatment whilst pyrazinamide is used in the inital phase of treatment only.

The bacteria that cause TB are difficult to treat. By using medications in combiation, the bacteria can be targeted in different ways and hence treatment is more likely to be effective than a single medicine alone. In addition, using different medications make it less likely that bacteria will develop resistance to treatment.

As the period of treatment is long the combination of the three drugs in one tablet helps compliance with the treatment.

Sample Q&A

Q. This is about our baby who is 13 months old. She was away in Coimbatore for about 3 weeks. When she came back to Chennai she had a very bad cold and cough. Upon checking with our doctor it was confirmed that she had severe chest congestion and due to that she was given medication. But even after this there was no let up and she continued having cough with phlegm coming out when she coughed and vomitted. Our doctor recommended doing a chest x-ray and Mantoux test. When this was done blood test revealed the following: Haemoglobin: 10 g%, Total leucocyte count: 12,400 cells, Polymorphs 42%, Lymphocytes 50%, Eosinophils 8%; Mantoux test +ve. I am unable to describe the x-ray because we did not get a report, but looking at the x-ray one side of the chest looked hazy and the other side quite clear. The doctor confirmed that she had primary complex. Now after medication she is quite better but continues to cough occasionally. My question is will she be cured or will it lead to TB since the doctor has given medication for 1 year?

A. Primary complex is an infection due to the Tuberculosis bacteria. When the full treatment course is completed, she should be completely cured. However, it is possible that at a later stage, the Primary Complex may get re-activated, if he general level of Health or Immunity were to decline in your daughter, for some reason.

SOURCE: http://www.doctorndtv.com/
http://en.wikipedia.org/wiki/Main_Page