Hubungan Positivitas BTA Pada Jaringan Biopsi Dengan Gambaran Klinis Pada Pasien Limfadenitis Tuberkulosis

Linda Junaedi, Sadeli Masria, Tryando Bhatara, Yani Triyani, Rita Herawati, Edi Gunardi

Abstract


Abstrak

Tuberkulosis (TB) adalah penyakit infeksi yang disebabkan oleh mycobacterium tuberculosis yang dapat menular. TB juga dapat mengenai organ lain diluar paru yang disebut dengan tuberkulosis ekstraparu (TBEP), TBEP terjadi karena adanya penyebaran bakteri M. Tuberculosis ke organ lain di dalam tubuh selain paru-paru, khususnya kelenjar getah bening (KGB) atau limfadenitis TB. Pemeriksaan BTA yang positif menandakan bahwa penyebabnya adalah mycobacterium dan spesifik oleh M. Tuberculosis pada dewasa. Pemeriksaan BTA dengan metode Ziehl Neelsen diklasifikasikan berdasarkan skala IUATLD yaitu negatif, +1,+2,+3. Penelitian ini bertujuan untuk menganalisis hubungan derajat positivitas BTA pada jaringan biopsi dengan gejala klinis pada pasien limfadenitis tuberkulosis. Terdapat 24 pasien yang memenuhi kriteria inklusi. Penelitian ini menggunakan desain penelitian potong lintang dengan metode analitik korelasi. Analisis data dilakukan dengan uji chi-square. Hasil menunjukkan bahwa tidak terdapat hubungan bermakna antara positivitas BTA dan gejala klinis dengan nilai p ≥0,50. M. Tuberculosis menyebabkan respon imun intraseluler terganggu dan respon proinflamasi terjadi dengan gejala pembengkakan pada KGB. Pembengkakan KGB terjadi setelah organisme ditangkap dan dikenali sebagai bahaya dan KGB menghasilkan sel-sel yang mampu menyerang organisme yang tidak diinginkan.

Tuberculosis is infection disease caused by Mycobacterium tuberculosis that can be transmitted. Tuberculosis can also affect other organs besides the lungs called extrapulmonary tuberculosis, extrapulmonary tuberculosis occurs because of the spread of M. tuberculosis bacteria to other organs in the body besides the lungs, specifically lymph node called lymphadenitis tuberculosis. A positive AFB result indicates a mycobacterium etiology and has excellent specificity for M. tuberculosis in adults. AFB examination by Ziehl Neelsen is classified into IUATLD scale, namely negative, +1, +2, +3. This study aims to examine the relationship between positivity degree of AFB from lymph node tissue and clinical features of lymphadenitis tuberculosis patient. There were 24 patient who met the inclusion criteria. This study used cross sectional design with correlation analytic method. Data analysis using chi square test. Result showed that there was not significant relationship between positivity of AFB and clinical features with p≥0,05. M. tuberculosis causes intracelullar immune responses to be disrupted and proinflammatory responses occur marked by swelling of lymph node. The lymph node swells up once the organism has been caught and recognised as harmful, the lymph node produce cells capable of attacking the unwanted organims.


Keywords


Bakteri Tahan Asam, gejala klinis, limfadenitis TB

Full Text:

PDF

References


Nassaji M, Azarhoush R, Ghorbani R, Kavian F. Acid fast staining in formalin-fixed tissue specimen of patients with extrapulmonary tuberculosis. Int J Sci Res Publ [Internet]. 2014;4(10):1. Available from: http://www.ijsrp.org/research-paper-1014.php?rp=P343200

Dinas Kesehatan JABAR. Profil Kesehatan Tahun 2015. 2016;(Dinas Kesehatan JABAR):173,174. Available from: http://www.depkes.go.id/resources/download/pusdatin/profil-kesehatan-indonesia/profil-kesehatan-Indonesia-2015.pdf

Badan Penelitian dan Pengembangan Kesehatan. Riset Kesehatan Dasar (RISKESDAS) 2013. Lap Nas 2013 [Internet]. 2013;69–70. Available from: http://www.depkes.go.id/resources/download/general/Hasil Riskesdas 2013.pdf

Azizi FH, Husin UA, Rusmartini T. Gambaran Karakteristik Tuberkulosis Paru Dan Ekstra Paru Di BBKPM Bandung Tahun 2014. 2014;860–6. Availablefrom: http://karyailmiah.unisba.ac.id/index.php/dokter/article/viewFile/1484/1201

Fauci A. Harrison Internal Medicine. 17th ed. 2008. 239 p.

Fontanilla J-M, Barnes A, von Reyn CF. Current Diagnosis and Management of Peripheral Tuberculous Lymphadenitis. Clin Infect Dis [Internet].2011;53(6):557–62. Available from: https://academic.oup.com/cid/article-lookup/doi/10.1093/cid/cir454

Salvador F, Los-Arcos I, Sánchez-Montalvá A, Tórtola T, Curran A, Villar A, et al. Epidemiology and diagnosis of tuberculous lymphadenitis in a tuberculosis low-burden country. Med (United States) [Internet]. 2015;94(4):3–5.Availablefrom: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4602977/pdf/medi-94-e509.pdf

Bhembe NL, Jaja IF, Nwodo UU, Okoh AI, Green E. Prevalence of tuberculous lymphadenitis in slaughtered cattle in Eastern Cape, South Africa. Int J Infect Dis [Internet]. 2017;61:27–30. Available from: http://dx.doi.org/10.1016/j.ijid.2017.05.005

Zewdie O, Abebe T, Mihret A, Hirpa E, Ameni G. Concentration of fine needle aspirates similar to molecular method improves sensitivity of the diagnosis of tuberculous lymphadenitis in Addis Ababa, Ethiopia. BMC Infect Dis [Internet]. 2017;17(1):1–7. Available from: http://dx.doi.org/10.1186/s12879-017-2194-2

Hande Senem Deveci, Mustafa Kule, Zeynep Altin Kule TEH. Diagnostic challenges in cervical tuberculous lymphadenitis: A review. 2016;3(2):150–5. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5206468/pdf/NCI-3-150.pdf

Tortoli E, Russo C, Piersimoni C, Mazzola E, Dal Monte P, Pascarella M, et al. Etiological study of lymphadenopathy in HIV-infected patients in a tertiary care hospital. J Cytol [Internet]. 2016;30(2):5–7. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4881407/?report=reader#!po=1.923

Antonaci F, Bovim G, Luisa M. Pain threshold in humans . A study with the pressure algometer PAIN THRESHOLD IN HUMANS . A STUDY WITH THE PRESSURE ALGOMETER. 1992;(April 2016).

Reddy S, Brown T, Drobniewski F. Detection of Mycobacterium tuberculosis from paraffin-embedded tissues by INNO-LiPA Rif.TB assay: Retrospective analyses of Health Protection Agency National Mycobacterium Reference Laboratory data. J Med Microbiol. 2010;59(5):563–6.




DOI: http://dx.doi.org/10.29313/kedokteran.v0i0.15040

Flag Counter    Â