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All Journal Journal of Tropical Life Science : International Journal of Theoretical, Experimental, and Applied Life Sciences Microbiology Indonesia Medical Journal of Indonesia Berkala Ilmu Kesehatan Kulit dan Kelamin Indonesian Journal of Tropical and Infectious Disease Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML) Jurnal Ilmu Kesehatan dan Gizi

INDROPO AGUSNI

Dept. Of Dermatology, School Of Medicine, Universitas Airlangga, Surabaya

Author-ID : 221708

Agriculture, Biological Sciences & Forestry Biochemistry, Genetics & Molecular Biology Earth & Planetary Sciences Environmental Science Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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COMPARATIVE STUDY ON THE INTENSITY OF Mycobacterium leprae EXPOSURE TO CHILDREN WHO LIVE IN LOW AND HIGH ALTITUDE IN LOW LEPROSY ENDEMIC AREA OF SOUTH SULAWESI Rachmawati, Rachmawati; Mataallo, Timurleng Tonang; Adam, Safruddin; Adam, A. M.; Amin, Safruddin; Tabri, Farida; Adriaty, Dinar; Wahyuni, Ratna; Iswahyudi, Iswahyudi; Agusni, Indropo
Indonesian Journal of Tropical and Infectious Disease Vol. 4 No. 4 (2013)
Publisher : Institute of Topical Disease Universitas Airlangga

Background: The intensity of Mycobacterium leprae exposure to people who live in leprosy endemic area could be measured by serological study and detection of the bacilli in the nose cavity. Different geographical altitude might have some influences to this exposure since the bacilli prefer to live in warm areas. Aim: A combined serological and PCR study of leprosy was conducted in Selayar island, South Sulawesi to 80 school children (40 from low land and 40 from highland altitudes) in order to compare the exposure intensity between the two areas. Method: Anti PGL-1 IgM antibody (ELISA) and PCR study to detect M.leprae in the nasal cavity were performed simultaneously from each person. Result: Seropositive cases were found in 23/40 children from low land compared to 16/40 children from high land, but statistically no significant difference (p>0.05). PCR positive for M.leprae in the nasal cavity only found in 1/40 children, both in low and high altitude. Conclusion: It is concluded that although the existence of M.leprae in nasal cavity is minimal, the intensity of exposure to this bacilli still high as indicated by serological study.

Mycobacterium leprae BACILLEMIA IN BOTH TWINS, BUT ONLY MANIFEST AS LEPROSY IN ONE SIBLING Sukmawati, Netty; Agusni, Indropo; Listiawan, M. Yulianto; Prakoeswa, Cita Rosita S.; Adriaty, Dinar; Wahyuni, Ratna; Iswahyudi, Iswahyudi
Indonesian Journal of Tropical and Infectious Disease Vol. 6 No. 1 (2016)
Publisher : Institute of Topical Disease Universitas Airlangga

Leprosy in twins is rarely reported. A 19 years-old male student, from Lamongan district, was diagnosed as Multibacillary (MB) leprosy in the Skin and STD Clinic of Dr. Soetomo General Hospital Surabaya. Multiple anesthetic skin lesions were found, but the bacteriologic examination was negative for Acid Fast Bacilli (AFB). Histopathology examination support the diagnosis of BL type of leprosy. His twin brother that has been lived together since born until present seems healthy without any complaints of skin lesions and have no signs of leprosy. When a serologic examination for leprosy was performed, a high anti PGL-1 antibody level was found in patient (IgM anti PGL-1 2937 and IgG anti PGL-1 3080 unit/ml) while his healthy twin brother showed only low level (IgM 745 and IgG 0 unit/ml). Interestingly when a PCR study was performed to detect M.leprae in the blood, both of them showed positive results. Using the TTC method, a genomic study of for M.leprae, it is revealed that both samples were identic ( 27x TTC repeats). According to patient's history, he had a traffic accident and got a wound in the knee seven years ago, while the skin lesions seems started from this area around three years ago before it spread to other parts of the body. The patient was treated with Multi-drug therapy (MDT) while his sibling got a prophylactic treatment for leprosy. After 6 months of treatment, the leprosy skin lesions were diminished and the serologic anti PGL 1 has been decreased. His healthy brother also showed a decrease in anti PGL 1 level and no skin signs of leprosy.

LYMPHOCYTE RESPONSE TO Mycobacterium leprae ANTIGENS IN REVERSAL REACTION STATE OF LEPROSY Yusuf, Irawan; Agusni, Indropo
Indonesian Journal of Tropical and Infectious Disease Vol. 5 No. 4 (2015)
Publisher : Institute of Topical Disease Universitas Airlangga

Reversal Reaction (RR) in Leprosy is a sudden inflammatory episode in the chronic course of the disease due to rapid change of cellular immunological status. The aim of the study is to measure the in vitro results of Lymphocyte Stimulation Index (LSI) RR leprosy derived lymphocytes after challenged with M.leprae antigens. Twenty three Borderline Leprosy with RR and 11 Borderline Leprosy patients without RR were included in the study. Peripheral Blood Mononuclear Cells (PBMC) were separated from peripheral blood of these patients using Ficol-Hypaque column and cultured in laboratory. Using the colorimetric tetrazole (MTT) method these lymphocytes were challenged with PHA, Dharmendra antigen (1/100 and 1/10 dilutions), LAM (50 and 100 nanograms). Stimulation Index were calculated and superanatans were collected for measuring the IFN-Î³ and IL-10 production (ELISA). All of lymphocytes from RR patients showed higher Stimulation Index after challenged with the five M.leprae antigens compared to lymphocytes from non RR patients (p <0.05) . IFN-Î³ and IL-10 also increased but not significant (p>0.05). It is concluded that lymphocytes of leprosy patients during RR state are more sensitive to antigenic stimuli compared to non-RR leprosy patients. Further extended studies are needed to determine the "cut off” value of lymphocyte Stimulation Index that is useful for clinicians in the field in the prediction of RR before starting anti leprotic treatment.

Mycobacterium leprae in Daily Water Resources of Inhabitants Who Live in Leprosy Endemic Area of East Java Wahyuni, Ratna; Adriaty, Dinar; iswahyudi, iswahyudi; Prakoeswa, Cita Rosita S.; Agusni, Indropo; izumi, shinzo
Indonesian Journal of Tropical and Infectious Disease Vol. 1 No. 2 (2010)
Publisher : Institute of Topical Disease Universitas Airlangga

Leprosy still a health problem in Indonesia, where many leprosy pocket areas still persists, especially in the eastern part of the country. Although the program of WHO – Multidrug Therapy (MDT) regiment has been conducted elsewhere since 1980s, only the prevalence can be reduced but not the incidence of new leprosy cases. Theoretically after the source of leprosy (the infectious leprosy cases) has been treated, no more transmission of the disease and should be no more new leprosy cases will be found. To explain this phenomenon, the non-human resource of M.leprae became a new topic of debates, especially the existence of bacteria in the environment. A field study of the existence of M.leprae in the environment of leprosy endemic area had been conducted in a leprosy endemic area of the northern part of East Java. The aim of the study is to find any correlation of the existence of these bacteria in the environment with the presence of leprosy patients who live in that area, in order to study its role in the transmission of the disease. Ninety water samples from wells in the house of inhabitants who live in one endemic sub district were collected. The owner of the well was interviewed whether any leprosy patients who routinely use the water for their daily life activities. Water samples were examined by Polymerase Chain Reaction (PCR) method to detect M.leprae DNA, using the LpF-LpR and Lp3-Lp4 nested primers (99bp). The PCR results showed positive band for M.leprae in 22 out of 90 (24%) water samples. Water samples from wells that used by leprosy patients showed positive PCR in 11/48 (23%), while 11 out of 42 (26%) water samples from wells that never been used by leprosy cases showed positive result. Statistically there was no difference (p>0.05) in the positivity of M.leprae between the two groups. It was concluded that the existence of M.leprae in the daily water resource was not correlated with the present of leprosy cases in the area. Possible symbiosis between protozoan and mycobacterium in the environment were discussed.

EVALUATION OF ANTI PCL-1 ANTIBODY TITER IN A GROUP OF HEALTHY SCHOOL CHILDREN WHO LIVE IN LEPROSY ENDEMIC AREA FROM 2007–2010 putri, rachmah diana; amiruddin, M. dali; tabri, farida; Adriaty, Dinar; Wahyuni, ratna; iswahyudi, iswahyudi; agusni, indropo; izumi, shinzo
Indonesian Journal of Tropical and Infectious Disease Vol. 1 No. 3 (2010)
Publisher : Institute of Topical Disease Universitas Airlangga

The "Iceberg phenomene” has been used to explain this situation which indicate that these new leprosy cases is originated from Subclinical Leprosy. Fifty eight healthy school children who live in Jeneponto Regency, a leprosy endemic area in South Sulawesi were recruited. The first examination was performed in 2007 and sera samples were kept in deep freeze refrigerator. In 2010 these children were re-examined for clinical leprosy and sera were collected again. ELISA study was performed simultaneously to these 58 pairs of sera (2007 & 2010) for measuring the titer of IgM anti PGL-1 antibody (ELISA) and the level 605u/ml was regarded as cut off value. After three years evaluation, none of these children showed any clinical signs of leprosy, but 20 of 22 ( 90.9%) children were remained sero-positive and only 2 (9.1%) became sero-negatives. In other sites, 5 children that previously sero-negatives became sero-positives after 3 years. Eight of 10 (80%) children who showed sero (+) with high titer (>1.000u/ml) in 2007, were also remained in high titer. The mean titer of 2007 was 627.8 u/ml, and after3 years became 723.9 u/ml (p<0.05). Although there is no progression from Subclinical to Manifest Leprosy cases among these children, the number of sero (+) cases were increased and the mean titer of IgM anti PGL-1 antibody was significantly increased.. The majority who previously showed high anti PGL-1 antibody titer, remained in high level. This study support the "iceberg phenomene” theory in Leprosy.

NORWEGIAN SCABIES IN AIDS PATIENT: A CASE REPORT Pratamasari, Meita Ardini; Agusni, Indropo; Prakoeswa, Cita Rosita Sigit; Astari, Linda; Sandhika, Willy
Indonesian Journal of Tropical and Infectious Disease Vol. 6 No. 2 (2016)
Publisher : Institute of Topical Disease Universitas Airlangga

Scabies is a skin infection caused by Sarcoptes scabiei var. hominis. This disease may present severe clinical manifestations in immune-compromised patient, well-known as Norwegian scabies or crusted scabies.A 36-year old man with AIDS had chief complaint thick crust almost all over his body in this case. History of household member infected by scabies before was present. Clinical findings show hyperpigmented macules unsharply marginated, covered with thick scales and accompanied by papules, fissures, and erotion. T cell CD4 level was 12 cell/Î¼L. Scraping examination showed scabies infection and so did the histopathology examination. This patient was treated by topical Permethrin 5% combined with 2-4 ointment application in between permethrin usage. Before topical scabicide was given, thick crust was previously treated by topical urea 10% and wet dressing by normal saline. On day 14 after the patient first came there was lesion improvement.

Histoid Leprosy Rinasari, Umi; Sawitri, Sawitri; Listiawan, M. Yulianto; Prakoeswa, Cita Rosita; Agusni, Indropo; Santoso, Rachmat; Izumi, Shinzo
Indonesian Journal of Tropical and Infectious Disease Vol. 1 No. 1 (2010)
Publisher : Institute of Topical Disease Universitas Airlangga

Histoid Leprosy is a variant of lepromatous leprosy with characteristic clinical and histopathological features. Usually it is occured in lepromatous patients who relaps after dapsone monotherapy, in those with dapsone resistance , sometimes even after multidrug treatment, or at times, de novo with characteristic clinical and histopathological features. A 36 years old male, originated from Papua, visited to the skin outpatient clinic with translucent shiny nodules on the left elbow and thumb for the last 18 months. The nodules were multiple, painless and firm. There were nasal congestion, tickening of ear lobes and loss of eye brows. Patient did not have any history of previous antileprotic treatment. Routine blood examination was normal. Bacteriological examination of slit skin smear revealed acid-fast bacilli of Bacterial Index 4+ and Morfologic Index 10%. Histopathology of skin suggested lepromatous leprosy of histoid type with characteristic interlacing bundles of spindle shaped cells. Anti-PGL1 antibody (ELISA) revealed high titer of IgM (>5.300 u/ml) and also IgG anti PGL-1 (>5.300 u/ml). Polymerase chain reaction examination test to detect M.leprae was positive and direct sequencing of M.leprae isolate shows no mutation, which means no resistancy to MDT treatment. Treatment with MDTWHO regiment give clinical improvements and the histoid lesions disappered after 3 months treatment.The histoid form of leprosy in this case developed without any prior treatment of anti leprotic drugs ( de novo ). Some theoretical aspects of the patho-mechanism of histoid leprosy are discussed.

TTC Repeats Variation of Mycobacterium leprae Isolates for Analysis of Leprosy Transmission in Leprosy Endemic Area in East Java, INDONESIA Adriaty, Dinar; Wahyuni, Ratna; Iswahyudi, Iswahyudi; Agusni, Indropo; Izumi, Shinzo
Indonesian Journal of Tropical and Infectious Disease Vol. 1 No. 1 (2010)
Publisher : Institute of Topical Disease Universitas Airlangga

East Java province still has some pocket of leprosy endemic areas. In order to solve the problem, molecular typing will make it feasible to study the transmission pattern of Mycobacterium leprae in leprosy endemic area. The present study is to analyze the presence of M.leprae DNA in the environment and to study variation number of TTC repeats and their distribution. Poteran Island is located in Madura, East Java and was chosen because this island has a high prevalence of leprosy and remains stable for the last five years. All samples were analyzed by PCR and the numbers of TTC repeats were confirmed by direct sequencing. Of all collected samples, 26.4% isolates of water resources (24); 61.9% nasal swabs (26); and 35.3% skin tissues (24) are positives. No statistically difference in the pattern distribution of TTC repeats between skin tissues of patients and nasal swab of households contact (p=0.594); also distribution of TTC repeats between skin tissues of leprosy patients and those of water resources (p=0.441); and distribution of TTC repeats between nasal swab of households contact with water resources (p=0.906). It means that the transmission of M.leprae in leprosy endemic area has closely related in 3 aspects: agent, host & environment.

LEPROSY AND HUMAN IMMUNODEFICIENCY VIRUS COINFECTION: A RARE CASE REPORT lydiawati, eva; Sirithida, Chukmol; Vannda, Sou; Vortey, Hak; Ratana, Heng; Listiawan, M. Yulianto; Agusni, Indropo
Indonesian Journal of Tropical and Infectious Disease Vol. 7 No. 4 (2019)
Publisher : Institute of Topical Disease Universitas Airlangga

Leprosy, or Hansen disease, is a chronic infectious disease caused by Mycobacterium leprae which is associated with inflammation that may damage the skin and the peripheral nerves. Leprosy remains an important public health problem in Southeast Asia, America, and Africa. It has been speculated that, as with TB, HIV infection may exacerbate leprosy lesions and/or lead to increased susceptibility to leprosy. We report the case of leprosy and HIV co-infection and reveals its clinical manifestation. A 34-year-old female came to outpatient clinic complaining of rednessplaque on her face of 2-months duration. It was also accompanied with thick sensation but without itchy or burning sensation. We found thick erythematous plaque with sharp margin and hypoesthesia on her face and body. There were no madarosis, saddle nose, lagophthalmos, nor sign of neuritis. The slit-skin smear revealed BI 1+ globi and MI 2%. From laboratory examination we found CBC was within normal limit, IgM anti PGL-1 titer was 1265 u/mL and IgG anti PGL-1 was 834 u/mL Both histological examination on her ear lobe and extremity revealed that was similar to the lesion of leprosy. The detection of HIV antibody was positive with CD4 count on 325 cells/Î¼L. We treat her with MDT for MB leprosy along with ART (Tenofovir, Lamivudine, and Efavirenz). After 6-months follow-up we observed no progression of the lesions though the slit-skin smear after completing 6 months of therapy become negative. M. leprae does not seem to accelerate the decline of immune function when associated with HIV infection. HIV infection does not seem to affect the clinical classification and progression of leprosy. Treatment of the HIV-leprosy co-infected patient consists of the combination of ARTs and anti-leprosy agents. So that, the treatment of leprosy and HIV co-infection does not differ from that of a seronegative leprosy patient.

Cutaneous Aspergilosis Caused by Aspergillus Flavus: A Case Report Sheilaadji, Maria Ulfa; Agusni, Indropo; Astari, Linda; Anggraeni, Sylvia; Widia, Yuri; Ervianti, Evy
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol. 33 No. 1 (2021): APRIL
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/bikk.V33.1.2021.72-77

Background: Cutaneous aspergillosis occurs relatively less frequent and therefore remains poorly characterized. Cutaneous aspergillosis can be as primary or secondary infection. Primary cutaneous aspergillosis usually involves sites of skin injury, intravenous catheter, traumatic inoculation, and associated with occlusive dressings. Secondary lesions result from contiguous extension from infected underlying structures or from widespread blood-borne seeding of the skin. Purpose: To know the skin manifestation, efflorence, examination and therapy of cutaneous aspergillosis. Case: A man complaint itchy redness macule and pimples on the right arm since 2 weeks. Initially just felt a little then expands. Patients with post operative brachial injury and uses a cast during one month. On examination there are erythematous macule unsharply marginated with papules. Potassium hydroxide examination, shows conidiophores, dichotomously branching and septate hyphae appropriate description with Aspergillosis Sp. Cultures found grow granular colonies, flat often with radial grooves, yellow at first but quickly becoming bright to dark yellow-green with age, For the identification microscope from the culture specimen there was conidia, phialde, conidiophore and vesicle that suitable with Aspergillus flavus. Patients received itraconazole 2 x 200 mg for 6 weeks and obtained satisfactory results. Discussion: Healthy hosts can develop cutaneous aspergillosis in surgical wounds, by traumatic inoculation, at sites associated with occlusive dressings. In some instances, a presumptive diagnosis of primary cutaneous aspergillosis can be made immediately by examining a potassium hydroxide preparation and culture. Conclusion: Diagnose of cutaneous aspergillosis can establish by potassium hydroxide and culture examination, therapy with itraconazole 2x 200mg give satisfactory results.

Co-Authors A. M. Adam, A. M. Afif Nurul Hidayati Afif Nurul Hidayati, Afif Nurul Agustina Tri Pujiastuti Anggraeni, Sylvia Anis Irawan Anwar Astindari Astindari, Astindari Aulia, Syifa Bambang Wirjatmadi Bimo Aksono Bimo Aksono Cita Prakoeswa, Cita Cita Rosita CITA ROSITA S. PRAKOESWA CITA ROSITA S. PRAKOESWA Cita Rosita Sigit Prakoeswa Cita Rosita, Cita Diah Mira I Diah Nugrahaeni Diah Nugrahaeni, Diah DINAR ADRIATY Dinar Ardiaty, Dinar Ditta Harnindya Dwi Murtiastutik Endang Retnowati Evy Ervianti Fanny Iskandar, Fanny Farida Tabri Febrina Dewi Pratiwi Friska Jifanti Halik Wijaya I G A Kencana Wulan I G A Kencana Wulan, I G A Kencana I G.A. Kencana Wulan I G.A. Kencana Wulan, I G.A. Kencana Icha Aisyah Indah Sari LD Irawan Yusuf Irma Tarida Listiyawati Irma Tarida Listiyawati, Irma Tarida ISWAHYUDI ISWAHYUDI Iswahyudi Iswahyudi Kinanti Prabawaningrum Kristina Sihaloho Linda Astari, Linda Lunni Gayatri Lunni Gayatri, Lunni Lydiawati, Eva M. dali amiruddin, M. dali M. Yulianto Listiawan Mansur Arif, Mansur Maylita Sari, Maylita Meita Ardini Pratamasari, Meita Ardini Mohammad Z. Rahfiludin Muhammad Dali Amiruddin Netty Sukmawati, Netty NI PUTU SUSARI Nuswantoro, Djohar Prakoeswa, Cita Rosita rachmah diana putri, rachmah diana Rachmawati Rachmawati Rahmadewi Rahmadewi Rahmatari, Bandaru Rasyidin Abdullah Ratana, Heng Ratna Wahyuni RATNA WAHYUNI Rinasari, Umi Safruddin Adam, Safruddin Safruddin Amin Santoso, Rachmat Sawitri Sawitri Sawitri Sawitri Sepling Paling SEPTIANA SEPTIANA Sheilaadji, Maria Ulfa SHINZO IZUMI SHINZO IZUMI SHINZO IZUMI Shinzo Izumi Sirithida, Chukmol Siti Kurniawati Tasalina Yohana Parameswari Gustam Timurleng Tonang Mataallo, Timurleng Tonang Toetik Koesbardiati Vannda, Sou Vortey, Hak Willy Sandhika Yoes P. Dahlan Yuniarti Arsyad, Yuniarti Yuri Widia, Yuri Yusuf Wibisono

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