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All Journal The Indonesian Journal of Infectious Diseases Jurnal Respirasi (JR) Indonesian Journal of Kidney and Hypertension Cermin Dunia Kedokteran
Sunaka, I Wayan
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Chronic Pulmonary Aspergillosis with Tracheobronchial Involvement Hermawan, Yosua Kevin; Pranata, Anak Agung Ngurah Satya; Putra, Wayan Wahyu Semara; Sunaka, I Wayan; Novitasari, Novitasari; Angelina, Cokorda Rio
Jurnal Respirasi Vol. 10 No. 3 (2024): September 2024
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v10-I.3.2024.249-256

Abstract

Introduction: Aspergillosis is a fungal infection commonly found in human lungs and takes several forms. Chronic pulmonary aspergillosis (CPA) commonly affects individuals with underlying disease, most usually lung tuberculosis (TB). Aspergillosis can cause the formation of a fungus ball in the lung cavity and can also manifest in the tracheobronchial area, although this is rarely seen in immunocompetent patients. Case: A 23-year-old woman came with persistent cough, hemoptysis, and shortness of breath for 4 months. The patient also had a significant weight loss and a history of lung TB 3 years ago. She had completed her lung TB medication. Physical examination showed increased respiratory rate and rhonchi on the left lung. GeneXpert showed no Mycobacterium tuberculosis (MTB) detected. The chest X-ray showed a cavity on the left superior lobe of the lung. Bronchoscopy showed multiple plaques along the trachea, carina, and left main bronchus. A chest computed tomography (CT) scan with contrast enhancement was performed, and a fungus ball was found inside the cavity in the left upper lobe of the lung. The patient was given intravenous fluconazole as therapy and continued with oral fluconazole when discharged. A second bronchoscopy was performed, and improvement was shown. Conclusion: Early detection and treatment should be applied to CPA patients since some studies showed poor prognosis and low five-year survival rates.
Neoplasia Limfoid yang Menyerupai Mesotelioma: Laporan Kasus Irianto; Puteri, Made Widya Wirayanti; Sunaka, I Wayan; Novitasari
Cermin Dunia Kedokteran Vol 52 No 6 (2025): Kesehatan Jiwa
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v52i6.1366

Abstract

Introduction: Lymphoid neoplasms are abnormalities of the hematopoiesis process of the lymphoid line, which can lead to lymphoma or leukemia. Mesothelioma is an abnormal mesothelial cell growth strongly associated with asbestos exposure. In radiology, mesothelioma is usually described as a tissue-dense lesion with well-defined, spiculated borders attached to the thoracic wall. The picture actually only depicts a tissue attached to the thorax, which can be suspected as mesothelioma, but can also be due to other disease processes, such as leukemia, lymphoma, and tuberculosis. Case: A 58-year-old man presented to the emergency room with complaints of shortness of breath. The patient was initially suspected of mesothelioma with suspicion of blood malignancy, but it turned out that the biopsy results were more likely to lead to infiltration of lymphoid neoplasms. Conclusion: In this patient, a lymphatic neoplasm infiltrated the mesothelial tissue and produced a well-demarcated and spiculated tissue picture resembling mesothelioma. Biopsy examination as the gold standard cannot be replaced by radiologic imaging at this time, as many other disease processes can mimic a malignancy.
Diagnostic Challenges of Weil’s Disease with Acute Kidney Injury: A Case Report and Clinical Review Agustini, Made Priska Arya; Dewi, Putu Itta Sandi lesmana; Lestari, I Dewa Ayu Made Dian; Sunaka, I Wayan
The Indonesian Journal of Infectious Diseases Vol. 11 No. 2 (2025): The Indonesian Journal of Infectious Diseases
Publisher : Rumah Sakit Penyakit Infeksi Prof Dr. Sulianti Saroso

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32667/ijid.v11i2.409

Abstract

Background: Severe leptospirosis or Weil’s disease can cause multi-organ failure, which is characterized by jaundice and acute kidney injury in approximately 10% of cases. Its nonspecific symptoms often lead to misdiagnosis with other acute febrile illnesses, resulting in delayed diagnosis. Case Presentation: A 48-year-old male construction worker presented with fever, headache, myalgia, epigastric pain, nausea, and vomiting for four days without any signs of bleeding. The patient lived and worked at a project site adjacent to rice fields. Physical examination revealed fever, icteric sclera, conjunctival suffusion, and tenderness of the gastrocnemius muscle. Laboratory tests showed leukocytosis, thrombocytopenia, impaired renal function, elevated liver enzymes, hyponatremia, and hypokalemia. The patient was diagnosed with Weill’s disease. He was treated with antibiotics and supportive therapy. Sixteen days after discharge, the patient reported gradual improvement and had resumed normal activities. Discussion:  Patients presenting with acute febrile illness should undergo a comprehensive evaluation, and leptospirosis should be considered when leukocytosis, neutrophilia, and thrombocytopenia are observed in a complete blood count. A detailed history focusing on risk factors and associated symptoms, along with additional diagnostic tests based on the criteria, can help guide the diagnosis. Antibiotic therapy should be initiated immediately in patients with suspected or probable leptospirosis without waiting for serological confirmation. Conclusion: This case highlights the diagnostic challenges of leptospirosis, particularly in resource-limited healthcare settings. Enhancing clinical awareness, improving access to rapid diagnostic tools, and optimizing preventive measures are crucial to reducing morbidity and mortality rates
Understanding Readmission Risks in End-Stage Kidney Disease: A Study from Wangaya Hospital Dewi, Ni Nyoman Gita Kharisma; Pratiwi, Made Sindy Astri; Agustini, Made Priska Arya; Dewi, Putu Itta Sandi Lesmana; Fahira, Cindy; Sunaka, I Wayan
Indonesian Journal of Kidney and Hypertension Vol 2 No 3 (2025): Volume 2 No. 3, December 2025
Publisher : PERNEFRI (PERHIMPUNAN NEFROLOGI INDONESIA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32867/inakidney.v2i3.206

Abstract

Background: End-stage kidney disease (ESKD) is a growing health burden. Poor patient knowledge and treatment adherence contribute to increased morbidity, as reflected in readmission rates. Objective: This study aimed to identify factors associated with readmission among ESKD patients in Bali. Methods: A retrospective cohort study was conducted at Wangaya Hospital. Adult patients (≥18 years) diagnosed with ESKD, with or without dialysis, between 2022 and 2024 were included. Patients with incomplete records or a solitary kidney were excluded. Bivariate analysis (chi-square test) and multivariate analysis (binary logistic regression) were used to assess associations, with significance set at p <0.05. Results: A total of 199 patients met the inclusion criteria; 61.8% were male, with a median age of 57 years (range: 22–88 years). Readmission rates within and beyond one month were 18.6% and 15.1%, respectively. Reduced eGFR was significantly associated with 30-day readmission (p = 0.041). For readmission beyond 30 days, significant predictors included diabetes mellitus (p = 0.014), neurologic disorders (p < 0.001), and adherence (p = 0.019). Conclusion: eGFR predicts early readmission, while diabetes mellitus, neurological disorders, and treatment adherence influence later readmissions. Identifying these factors is vital for improving patient education and reducing healthcare burdens.
Co-Authors Agustini, Made Priska Arya Angelina, Cokorda Rio Dewi, Ni Nyoman Gita Kharisma Dewi, Putu Itta Sandi Lesmana Fahira, Cindy Hermawan, Yosua Kevin Irianto Lestari, I Dewa Ayu Made Dian NOVITASARI Novitasari Novitasari Pranata, Anak Agung Ngurah Satya Pratiwi, Made Sindy Astri Puteri, Made Widya Wirayanti Putra, Wayan Wahyu Semara