Pendahuluan. Diagnosis tuberkulosis (TB) pada anak merupakan masalah tersendiri karena manifestasi klinis yang beragam dan tidak tersedianya standar baku penegakan diagnosis. Kasus. Anak perempuan usia 6 tahun, dengan klinis demam, batuk, dan sesak napas. Pada pemeriksaan fisik didapatkan penurunan suara napas di rongga dada kanan. Hasil pemeriksaan radiologi didukung ultrasonografi tampak gambaran efusi pleura kanan yang sebagian sudah terorganisasi. Hasil uji laboratorium didapatkan leukositosis dan hasil tes IGRA negatif. Analisis cairan pleura menunjukkan peningkatan kadar adenosine deaminase. Pengobatan TB menghasilkan perbaikan klinis dan radiologi bermakna. Simpulan. Pemeriksaan adenosine deaminase dapat dipertimbangkan untuk alternatif diagnosis TB pada anak. Diagnosis of tuberculosis (TB) in children is still problematic because of various clinical manifestations and the unavailability of diagnostic standard. Case. A 6-year old girl with fever, cough, and shortness of breath. On physical examination, there was a decreased breath sounds in the right chest. Radiology examination showed a partially organized right pleural effusion, supported with ultrasound finding. Lab test found leucocytosis and IGRA test was negative. Pleural fluid analysis showed increased adenosine deaminase level. TB treatment resulted in significant clinical and radiological improvement. Conclusion. Adenosine deaminase test can be considered as an alternative to TB diagnosis in children.

<p>Pendahuluan. Diagnostik tuberkulosis (TB) pada anak merupakan masalah tersendiri karena manifestasi klinis yang beragam dan tidak tersedianya standar baku penegakan diagnosis. Kasus. Anak perempuan usia 6 tahun, dengan klinis demam, batuk, dan sesak nafas. Pada pemeriksaan fisik didapatkan penurunan suara napas di rongga dada kanan. Hasil pemeriksaan radiologis didukung ultrasonografi tampak gambaran efusi pleura kanan yang sebagian sudah terorganisasi. Hasil uji laboratorium didapatkan leukositosis dan hasil tes IGRA negatif. Analisis cairan pleura menunjukkan peningkatan kadar adenosin deaminase. Pengobatan TB menghasilkan perbaikan klinis dan radiologis bermakna. Simpulan. Pemeriksaan adenosin deaminase dapat dipertimbangkan untuk alternatif diagnosis TB pada anak.</p><p>Diagnosis of tuberculosis (TB) in children is still problematic because of various clinical manifestations and the unavailability of diagnostic standard. Case. A 6-year old girl with fever, cough and shortness of breath. On physical examination, there was a decrease breath sounds in the right chest. Radiology examination showed a partially organized right pleural effusion, supported with ultrasound finding. Lab test found leucocytosis and IGRA test was negative. Pleural fluid analysis showed increased adenosine deaminase level. TB treatment resulted in significant clinical and radiological improvement. Conclusion. Adenosine deaminase test can be considered as an alternative for TB diagnosis in children.</p><p> </p>