Bronchopneumonia with Suspected Pulmonary Tuberculosis, Thrombocytopenia, Malnutrition, and Incomplete Immunization in a 9-Month-Old Infant: A Case Report
DOI:
https://doi.org/10.53089/medula.v16i4.1848Keywords:
Bronchopneumonia, immunization, malnutrition, pulmonary tuberculosis, thrombocytopeniaAbstract
Bronchopneumonia remains the leading cause of morbidity in infants, especially in developing countries, and can be exacerbated by various comorbid factors such as poor nutritional status, incomplete immunization, and possible chronic infections. This case report aims to describe the clinical course, diagnostic challenges, and management of complex bronchopneumonia in a 9-month-old infant with suspected pulmonary tuberculosis and thrombocytopenia. The method used was a descriptive case report of a 9-month-old male infant who was treated with the main complaints of shortness of breath, chronic cough with phlegm, intermittent fever, and accompanied by weight loss. Data were obtained through anamnesis, physical examination, laboratory and radiological support examinations, and observation during treatment. The results showed that the patient had recurrent bronchopneumonia with findings of respiratory distress, early thrombocytopenia, an increase in LED levels indicating the onset of an inflammatory process, poor nutritional status, and incomplete basic immunization. A pediatric tuberculosis score of 3 led to suspicion of pulmonary TB, although definitive tests had not yet been obtained. Empirical antibiotic therapy, supportive therapy, nebulization, and chest physiotherapy provided gradual clinical improvement. In conclusion, bronchopneumonia in infants with multiple risk factors requires a holistic approach and high alertness to the possibility of chronic infection and comorbidities. A comprehensive evaluation of nutritional status, immunization, and environmental factors is essential to prevent recurrence and improve patient clinical outcomes.
References
Binuko KPE, Wahyuni D. Seorang anak perempuan usia 8 tahun dengan bronkopneumonia. Proceeding Book Call for Papers Fakultas Kedokteran Universitas Muhammadiyah Surakarta. 2024;80:80–86.
Roh EJ, Shim JY, Chung EH. Epidemiology and surveillance implications of community-acquired pneumonia in children. Clin Exp Pediatr. 2022;65(12):563.
Sumantri W, Khaerina R, Lestari H. Status gizi dengan kejadian pneumonia pada balita di RSUD Provinsi NTB tahun 2024. Jurnal Ilmiah Ilmu Kesehatan. 2025;11(2).
Mani CS. Acute pneumonia and its complications. In: Long SS, Prober CG, Fischer M, editors. Principles and Practice of Pediatric Infectious Diseases. 5th ed. Philadelphia: Elsevier; 2017. p. 238.
Brajadenta G, Patra S, Tjandrarini DH. Faktor risiko usia anak (0–5 tahun) terhadap kejadian tuberkulosis paru pada anak. J Kedokt USU. 2019;26(2):72–78.
Kementerian Kesehatan Republik Indonesia. Pedoman Nasional Pelayanan Kedokteran Tatalaksana Tuberkulosis. Jakarta: Kementerian Kesehatan RI; 2021.
Khan R, Malik NI, Razaque A. Imaging of pulmonary post-tuberculosis sequelae. Pak J Med Sci. 2020;36(S1):S75.
Wang WH, Urbina AN, Chang MR, Lu WAP, Yen HC, Sheng FW. Dengue hemorrhagic fever: a systematic literature review of current perspectives on pathogenesis, prevention, and control. J Microbiol Immunol Infect. 2020;53(6):963–978.
Gwee XWS, Chua PEY, Pang J. Global dengue importation: a systematic review. BMC Infect Dis. 2021;21(1):1078.
Putri TY, Ekowati RAR, Ismawati. Hubungan cakupan imunisasi dasar dengan status gizi pada balita. Bandung Conf Ser Med Sci. 2025;5(1):635–642.
Ariati LIP. Faktor-faktor risiko penyebab terjadinya stunting pada balita usia 23–59 bulan. Oksitosin J Ilm Kebidanan. 2019;6(1):28–37.
Afrida I. Hubungan ASI eksklusif dan status imunisasi dengan kejadian stunting di wilayah kerja Puskesmas Bowong Cindea Kabupaten Pangkep. Community. 2020;2(3):106–112.
Jannah M, et al. Analisis faktor risiko yang berhubungan dengan kejadian pneumonia balita di wilayah kerja UPTD Puskesmas Banda Raya Kota Banda Aceh tahun 2019. J Kesehat Masy Aceh. 2020;6(1):20–28.
Popovsky EY, Florin TA. Community-acquired pneumonia in childhood. In: Encyclopedia of Respiratory Medicine. 2nd ed. Chicago: Elsevier; 2022. p. 119–131.
Sidiq R, et al. The risk of pneumonia among toddlers in Lambatee. Kesmas Natl Public Health J. 2016;11(2):69–73.
Rahayuningrum DC, Nur SA. Hubungan status gizi dan status imunisasi dengan kejadian infeksi saluran pernapasan akut pada balita Kota Padang. J Kesehat Mesencephalon. 2021;7(1).
Susiyanti, Mawarti L, Ilmi AK. Gambaran hasil pemeriksaan laju endap darah (LED) menggunakan metode Westergren pada pasien rawat jalan. J Kesehat Terapan. 2021;8(1):44–49.
Putri D, Arifin S, Evawany A. Hubungan status gizi, pemberian ASI eksklusif, dan status imunisasi dasar dengan kejadian pneumonia pada anak usia 12–24 bulan di wilayah kerja Puskesmas Glugur Darat Kota Medan. 2015;17.
Ratnaningtyas, Pradigdo SF, Mawarni A. Faktor risiko kejadian pneumonia pada anak usia 12–48 bulan (studi di wilayah kerja Puskesmas Gombong II Kabupaten Kebumen tahun 2017). 2018;6:581–590.
Efni Y, Machmud R, Pertiwi D. Faktor risiko yang berhubungan dengan kejadian pneumonia pada balita di Kelurahan Air Tawar Barat Padang. 2016;5(2):365–370.
World Health Organization. Pocket Book of Hospital Care for Children: Guidelines for the Management of Common Childhood Illnesses. 3rd Edition. Geneva: WHO; 2022.
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