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All Journal Deka in Medicine Malahayati International Journal of Nursing and Health Science
Subianto, Aries
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health

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Successful resolution of mesenteric tuberculosis and HIV co-infection following 6 months of anti-tuberculosis therapy: a case report Maulidiyah, Novita; Wicaksono, Ramadi; Retnowulan, Aisyah; Santoso, Budi; Subianto, Aries; Mashudi, Latifah; Kurniawan, Fajar
Deka in Medicine Vol. 1 No. 1 (2024): April 2024
Publisher : PT. DEKA RESEARCH INSTITUTE

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69863/dim.v1i1.2

Abstract

BACKGROUND: Mesenteric tuberculosis (TB), a rare extrapulmonary variant of TB, poses diagnostic and therapeutic challenges in its management. Therefore, discussing a case of mesenteric TB is both intriguing and informative for gaining insights into its clinical presentation and optimal treatment strategies. CASE PRESENTATION: A 50-year-old male presented symptoms of blackish stools three days post-gallstone surgery, accompanied by approximately two months of abdominal discomfort, described as squeezing or stabbing, alleviated temporarily by analgesics, alongside abdominal distension, rigidity, decreased appetite, and afternoon fevers. Physical examination revealed normal vital signs, with pale conjunctiva and asymmetrical chest wall movement, dull percussion, and decreased breath sounds in the lower left hemithorax. Abdominal inspection indicated distension, postsurgical signs, and ascites. Following laboratory investigations, chest and abdominal radiographs, and tissue biopsies, the patient was diagnosed with HIV co-infection along with pulmonary and mesenteric TB. Treatment comprised an intensive phase of four fixed-dose combinations (FDC) of anti-TB drugs, followed by a continuation phase of two FDC tablets, alongside first-line antiretroviral (ARV) therapy and cotrimoxazole prophylaxis. By the sixth month follow-up, clinical improvement was observed, with resolution of symptoms and weight gain to 56 kg. CONCLUSION: This case highlights the effective management of mesenteric TB and HIV co-infection, emphasizing the importance of comprehensive care and collaborative efforts between TB and HIV/AIDS control programs.
Successful resolution of a tuberculous bronchopleural fistula presenting as recurrent pneumothorax in an atypical host: A case report Aristia, Lintang Briliana; Subianto, Aries
Malahayati International Journal of Nursing and Health Science Vol. 8 No. 12 (2026): Volume 8 Number 12
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/minh.v8i12.1750

Abstract

Background: Secondary spontaneous pneumothorax (SSP) occurs in approximately 1-1.5% active tuberculosis (TB) cases, frequently progressing to a bronchopleural fistula (BPF) with a 2.89-fold increased risk. TB remains the primary etiology of SSP in high-burden regions like Indonesia, causing 46.15% of cases. Purpose: To describe the clinical presentation, diagnostic challenges, and successful multimodal management of a tuberculous bronchopleural fistula presenting as recurrent pneumothorax in an atypical host. Method: This descriptive analytic research used a case study approach involving a 43-year-old man patient with left-sided Secondary Spontaneous Pneumothorax attributed to underlying pulmonary tuberculosis at the Achmad Yani Surabaya Islamic Hospital. Data were collected through interviews, observation, physical examinations, medical records, and diagnostic documentation, using a head-to-toe assessment format. Data analysis was conducted concurrently with data collection, comparing findings with existing theories to support discussion and intervention recommendations. The analysis was narrative and observational, aiming to interpret the patient’s condition in relation to theoretical knowledge. Results: This case uniquely highlights tuberculous SSP in an immunocompetent host, underscoring the critical need for a high index of suspicion for TB, even without classic constitutional symptoms. Conservative therapy became innefective due to a persistent air leak which strongly indicated a BPF, a recognized complication in 69.2% of similar cases. This finding justified escalation to surgical management, aligning with international guidelines. The integrated multimodal management strategy proved crucial for a successful outcome. Conclusion: Active TB must be considered a primary differential diagnosis for SSP in endemic settings, regardless of typical clinical presentation. A persistent BPF demands definitive surgical intervention. The combination approach of ATT followed by VATS wedge resection and pleurodesis represents a highly effective and conclusive management strategy for these challenging cases.
Co-Authors Aristia, Lintang Briliana Dwi Budi Santoso Fajar Kurniawan Mashudi, Latifah Maulidiyah, Novita Retnowulan, Aisyah Wicaksono, Ramadi