Pranata, Anak Agung Ngurah Satya
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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.
Therapeutic Strategy for Recurrent Ulcerative Colitis Pranata, Anak Agung Ngurah Satya; Wirawan, I Made Suma; Kumala Dewi, Anak Agung Istri Sri; ., Novitasari
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 25, No 3 (2024): VOLUME 25, NUMBER 3, December, 2024
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/253202484-89

Abstract

Ulcerative Colitis (UC) is a chronic idiopathic inflammation that appears from the rectum and can extend to colon causing diffuse friability and superficiality. In this case report, Woman, 44 years old, admitted to hospital because of bloody diarrhea, frequency of 4-6 times daily with mucous, malaise, and history of weight loss. Patient already had oral sulfasalazine and oral corticosteroid to maintain her condition, but she stopped the medication at will. On physical examination, showed anemic conjunctiva and increasing in bowel sound, fecal examination showed brown to red, porridge-like consistency, blood, mucous, and positive Benzidine test. Colonoscopy examination revealed, normal anus; in the sigmoid rectum, colon descendent found small swellings, an ulcer, and few bloody. On histopathology, epithelial surface with mucin depletiondistortion of crypt architecture, dilatation and elongation of crypt, as well as shortening of the crypt that does not reach muscular mucous and lamina propria contains solid aggregate inflammation cells, dominated by plasma cells. The patient was given  combination of 5-aminosalicylates and glucocorticoids. On re-evaluation in week 8 of therapy, frequency of defecation becomes 1-2 times daily with no blood occurring and improvement on colonoscopy, rectal mucous, colon sigmoid improved, no bleeding and clean mucous.  5-aminosalicylates is the first treatment in UC,  it also helps to achieve remission and prevent carcinoma development. UC is a disease that also causes extra-intestinal manifestation, so the treatment should be done holistically. Compliance and regular monitoring will help to improve the quality of life.