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All Journal Jurnal Locus Penelitian dan Pengabdian Bali Medical and Wellness Journal
Pratama, Gede Made Cahya Trisna
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Aerospace Engineering Automotive Engineering Decision Sciences, Operations Research & Management Dentistry Electrical & Electronics Engineering Health Professions Mathematics Medicine & Pharmacology Nursing Public Health

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Liver Abscess as a Rare Complication of Typhoid Fever in a Young Adult: A Case Report Pratama, Gede Made Cahya Trisna; Putra, I Komang Wisuda Dwija
Jurnal Locus Penelitian dan Pengabdian Vol. 5 No. 1 (2026): JURNAL LOCUS: Penelitian dan Pengabdian
Publisher : Riviera Publishing

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58344/locus.v5i1.5391

Abstract

Typhoid fever, caused by Salmonella typhi, remains a significant endemic infection in developing countries. While its gastrointestinal and systemic symptoms are well known, liver abscess as a complication is exceedingly rare. This case report highlights the clinical significance of recognizing atypical presentations, particularly in resource-limited settings with common delayed diagnosis. The condition arises from hematogenous spread of Salmonella typhi in delayed or untreated cases, leading to localized hepatic infection and abscess formation. This descriptive case report documents this rare complication. A 19-year-old male presented with persistent high-grade fever, malaise, headache, and right upper quadrant abdominal pain, plus a history of hematochezia. Examination revealed fever, anemic conjunctivae, and hepatomegaly. Labs showed leukocytosis with neutrophilia, microcytic anemia, elevated liver enzymes, and positive fecal occult blood. The TUBEX TF test was reactive for IgM against Salmonella typhi. Abdominal ultrasonography and contrast-enhanced CT confirmed a solitary liver abscess. Initial ceftriaxone monotherapy yielded limited response; significant improvement followed added intravenous metronidazole. A 19-year-old male presented with persistent high-grade fever, malaise, headache, and right upper quadrant abdominal pain, plus a history of hematochezia. Examination revealed fever, anemic conjunctivae, and hepatomegaly. Labs showed leukocytosis with neutrophilia, microcytic anemia, elevated liver enzymes, and positive fecal occult blood. The TUBEX TF test was reactive for IgM against Salmonella typhi. Abdominal ultrasonography and contrast-enhanced CT confirmed a solitary liver abscess. Initial ceftriaxone monotherapy yielded limited response; significant improvement followed added intravenous metronidazole.
Efficacy of Levothyroxine (LT4) and Liothyronine (T3) Combination Therapy vs. LT4 Monotherapy for Hypothyroidism: A Meta-Analysis Pratama, Gede Made Cahya Trisna; Wulandari, Dewi Catur
Bali Medical and Wellness Journal Vol. 3 No. 1 (2026): Bali Medical and Wellness Journal
Publisher : PT BMW Journal Sejahtera

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71341/bmwj.v3i1.56

Abstract

Background: Levothyroxine (LT4) monotherapy is the standard treatment for hypothyroidism, using serum thyroid-stimulating hormone (TSH) as the primary indicator of therapeutic adequacy. However, many patients remain symptomatic despite achieving normal TSH levels. Objectives: This meta-analysis evaluates the biochemical and metabolic efficacy of adding liothyronine (T3) to LT4 compared to standard monotherapy. Method: A systematic search was conducted to identify randomized controlled trials (RCTs) comparing LT4+T3 combination therapy with LT4 monotherapy in adults. TSH was the primary outcome, while secondary outcomes included free T4 (fT4), total T3, lipid profiles, and body weight. Results: Seven RCTs involving 355 participants were analyzed. Biochemical outcomes showed no significant difference in TSH suppression (P=0.40) or total T3 levels (P=0.38) between groups. Notably, LT4 monotherapy resulted in significantly higher fT4 levels (MD=0.27; 95%CI: 0.13, 0.40; P=0.0001). Regarding metabolic outcomes, combination therapy significantly improved LDL cholesterol (MD=4.79; 95%CI: 1.63, 7.96; P=0.003) with zero heterogeneity (I2=0%). A borderline significant trend toward weight reduction was also observed in the combination group (MD=-2.26; 95%CI: -4.52, 0.01; P=0.05). Conclusion: Compared to monotherapy, LT4+T3 combination therapy provides significant metabolic advantages, particularly in LDL reduction, while maintaining biochemical euthyroidism.
Co-Authors Dewi Catur Wulandari Putra, I Komang Wisuda Dwija