Bronkiektasis dengan Emfisema Bulosa pada Pasien Post Tuberkulosis Paru : Sebuah Studi Kasus

Abstract

Background: Bronchiectasis is a chronic lung disease characterized by persistent irreversible bronchial dilatation, accompanied by an inflammatory process in the bronchial wall. Previously, the prevalence of bronchiectasis was not widely known, but global statistics show that the incidence of bronchiectasis has increased over the past few years and can affect all age groups. In Indonesia, there is no exact report on this disease, but it is quite common in clinics or hospitals. The aim of this study was to report a case of bronchiectasis with bullous emphysema on patient post pulmonary tuberculosis in a 63-year-old-woman at Bethesda Hospital, Yogyakarta.
Methods: This type of research is a case report of bronchiectasis with bullous emphysema on patient post pulmonary tuberculosis in a 63-year-old-woman at Bethesda Hospital, Yogyakarta.
Results: A 63-year-old woman presented with complaints of post-pulmonary TB treatment control, accompanied by minimal cough and sometimes experiencing shortness of breath. The patient was diagnosed with TB on May 18th 2022 and has been on TB treatment for 9 months, until being diagnosed with recovery by a doctor on March 27th 2023. The patient has a history of gastritis, anorexia, and allergy to ethambutol. The patient's condition when entering the hospital was compos mentis with a total GCS of 15 (E4V5M6) but appeared weak, blood pressure 120/70 mmHg, pulse rate 84 times/minute, respiratory rate 22 times/minute, SpO2 98% and temperature 36,4oC. On physical examination of the lungs, basic vesicular sounds were found +/+, crackles -/-, and wheezing +/-. HRCT of the thorax showed a mark of volume loss in the right lung with bronchiectasis-surrounding fibrotic lines and an initial process of bronchiectasis in the anteroposterior lobe segment of left lung, suggestive of post TB infection.
Conclusions: Bronchiectasis is characterized by irreversible and persistent bronchial dilatation, accompanied by an inflammatory process in the bronchial wall and lung parenchyma. The most common etiology of bronchiectasis is post-pulmonary infection, such as tuberculosis. Bronchiectasis-induced TB can also give a picture of multiple bullae of the lungs, called bullous emphysema. The diagnosis of bronchiectasis is based on clinical presentation and imaging. Adequate treatment of pulmonary TB infection and appropriate lifestyle modifications are urgently needed, to minimize lung damage that may be caused after TB infection.