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All Journal Folia Medica Indonesiana Jurnal Ilmiah Kedokteran Wijaya Kusuma
Tjan, Anastasia
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Biochemistry, Genetics & Molecular Biology Medicine & Pharmacology Public Health Other

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Penyengatan Meningeal Sisterna Basalis Meningitis TB pada Computed Tomography Scanning: Sebuah Ulasan Bergambar Tjan, Anastasia; Asih, Made Widhi; Martadiani, Elysanti Dwi
Jurnal Ilmiah Kedokteran Wijaya Kusuma Vol 8, No 2 (2019): EDISI SEPTEMBER 2019 (available online since Oktober 2019)
Publisher : Universitas Wijaya Kusuma Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1233.025 KB) | DOI: 10.30742/jikw.v8i2.623

Abstract

Tuberculosis (TB) is one of the major worldwide threat and global burden in Indonesia. CNS tuberculosis is the most severe form of TB infection. CT evaluation on diagnosing tuberculosis meningitis (TBM) with triad of hydrocephalus, basal meningeal enhancement and infarction was reported to be sensitive. PCR cerebrospinal fluid (CSF) is known to be specific, however negative results have been reported due to presence of PCR?s inhibitors, poor lysis of mycobacteria, and the uneven distribution in specimens. CT Scan plays the vital role in diagnosing TBM patient with the presence of TBM CT triad, especially basal cistern enhancement (BME) which is the specific enhancement pattern in MTB patient. There are 9 must know BME pattern, such as contrast filling the cistern, double and triple line, linear enhancement at MCA cistern, Y sign, posterior infundibular recess enhancement, ill defined border, join the dots sign, nodular enhancement, and asymmetry off all pattern. Familiarizing BME criteria is essential to provide confident diagnosis and reduce morbidity and mortality
Semilunar Sign of Trans-Mediastinal Herniation of Giant Bullae with Tension Hydropneumothrax Tjan, Anastasia; Dwija Putra Ayusta, I Made; Mahiswara, Dewa Gde
Folia Medica Indonesiana Vol. 56 No. 4 (2020): December
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1035.715 KB) | DOI: 10.20473/fmi.v56i4.24652

Abstract

Herniation of bulla across mediastinum is rare, while transmediastinal giant bulla herniation accompanied with hydropneumothorax is even rarer. We report a case of an 18 years old male with dyspnea came to emergency department with trans-mediastinal giant bulla herniation, which appears as semilunar sign on chest x-ray, and righthydropneumothoraks. It appeared that the giant bulla also infected by the presence of air fluid level within. Semilunar sign was seen on the contralateral left mediastinum as the hallmark finding for trans-mediastinal herniation of bulla. Chest CT further confirms the diagnosis. Subsequently chest tube insertion and symptomatic relives were given, however the patient end up dead after 2 days of observation. Heart and lung compression by the lesions were the cause of this patient poor outcome. Bullous lung disease should be evaluated thoroughly and not underestimated since it could cause severe disease progression. 
Co-Authors Dwija Putra Ayusta, I Made Elysanti Dwi Martadiani Made Widhi Asih Mahiswara, Dewa Gde Narasiang, Benefit Sherwin R.U.A. Sompie