Tuberculosis

There are so many patients with Tuberculosis at the hospital. They all stay for 2 months to complete their intensive treatment. After the two months, hopefully with the routine, they will be compliant and continue another 4 months of TB treatment at home. So far the TB treatment seems to be working so no resistant yet in PNG. In the short time I've been here, I've seen all forms of TB--lung, spine, joint, lymph nodes, abdomen...etc.... Here are pictures of some of the obvious ones. They still present quite late. The problem is they keep coming back because the primary case prob the coughing grandmother or grandfather is still at home. So once they're treated, they go home and get infected again, or later their siblings gets admitted. So we're trying to do contact tracing but it's hard as some of them live in villages far away and it's difficult to get them to come to the hospital for a review. I belive the TB problem with get worse. And if resistant arrives as it has done in Africa already, and with the increase of HIV, it can become a very serious problem.


This man above has enlarged lymph nodes everywhere. This is probably one of the worse ones because he left it so long and not got any treatment that he developed discharging sinuses from the lymph nodes. I have so many kids with enlarged lymph nodes in the neck which are resistant to antibiotics, and when you put them on TB drugs, it starts softening and reducing in size. It still takes a good few months for the lymph nodes to disappear. On ultrasound, these lymph nodes look cystic (looks like they are filled with fluid)


Above is a picture of a middle age woman who could barely walk. She weigh about 40kg. She definitely have TB as the only clinical symptom is on examination there is bronchial breathing in her left supraclavicular fossa. Other part of the lungs were completely clear.

Above is a picture of a healed TB of the Spine (Pott's disease). There is a hump which she has to live for the rest of her life. At least it's healed and she can walk and there are no more symptoms.