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Leukopenia as a Prognostic Factor in Severe Community-Acquired Pneumonia with Sepsis: A Case Report Irawan, Dandy; Irvan Medison; Dewi Wahyu Fitrina; Dessy Mizarti
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 12 (2024): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v8i12.1149

Background: Community-acquired pneumonia (CAP) is a major cause of sepsis, and severe CAP with sepsis is associated with significant morbidity and mortality. Leukopenia, a decrease in white blood cell count, has been identified as a potential prognostic factor in sepsis, suggesting a poorer outcome. This case report aims to evaluate the role of leukopenia in predicting the clinical course and outcome of a patient with severe CAP and sepsis. Case presentation: A 73-year-old male presented with complaints of shortness of breath, cough, fever, and altered mental status. He was diagnosed with severe CAP with sepsis and sepsis-associated encephalopathy (SAE). Laboratory investigations revealed leukopenia. The patient's clinical condition improved over 10 days of treatment, coinciding with an improvement in his white blood cell count. Conclusion: This case report highlights the potential prognostic value of leukopenia in patients with severe CAP and sepsis. The patient's clinical improvement paralleled the recovery of his white blood cell count, suggesting that leukopenia may serve as a marker of disease severity and treatment response. Further studies are needed to validate these findings and establish the role of leukopenia in the management of severe CAP with sepsis.

Pleural Amebiasis Mimicking Pleural Effusion: A Case Report Sari Handayani Utami; Irvan Medison; Dewi Wahyu Fitrina; Dessy Mizarti
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 1 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i1.1168

Background: Pleural amebiasis is a rare manifestation of extraintestinal amebiasis, primarily occurring due to the rupture of an amebic liver abscess into the pleural space. We present an unusual case of pleural amebiasis in an elderly woman without any evidence of liver involvement. Case presentation: A 78-year-old female presented with a two-month history of progressive dyspnea, cough, and right-sided chest pain. She had a history of consuming raw vegetables. Examination revealed right-sided pleural effusion, which was confirmed by chest radiography and thoracic ultrasound. Pleural fluid analysis showed exudative effusion and microscopic examination demonstrated the presence of Entamoeba histolytica trophozoites. Despite the absence of a liver abscess on abdominal ultrasound, the patient was diagnosed with pleural amebiasis based on the pleural fluid findings. She was successfully treated with metronidazole and drainage of the pleural fluid. Conclusion: This case highlights the importance of considering pleural amebiasis as a differential diagnosis in patients with pleural effusion, even in the absence of liver involvement. Early diagnosis and prompt treatment with metronidazole and drainage are crucial for a favorable outcome.

Massive Hemoptysis: A Meta-Analysis of Urgent Interventional Approaches Bambang Rojullun Taufik; Russilawati; Dewi Wahyu Fitrina
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 5 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i5.1272

Background: Massive hemoptysis is a life-threatening medical emergency requiring immediate intervention. This meta-analysis evaluated the efficacy and safety of urgent interventional approaches for managing massive hemoptysis. Methods: A systematic search of electronic databases (PubMed, Embase, Scopus) was conducted from January 2013 to February 2024. Studies comparing different urgent interventional approaches (bronchial artery embolization [BAE], bronchoscopic interventions, surgery) in adults with massive hemoptysis were included. The primary outcome was treatment success (cessation of bleeding). Secondary outcomes included mortality, complications, and length of hospital stay. Results: Nine studies (n=1145 patients) were included. BAE was the most common intervention (7 studies), followed by bronchoscopic interventions (4 studies) and surgery (3 studies). Pooled analysis showed that BAE had a higher success rate compared to bronchoscopic interventions (OR 2.15, 95% CI 1.32-3.51, p=0.002) and surgery (OR 1.88, 95% CI 1.15-3.08, p=0.01). BAE was associated with a lower mortality rate compared to surgery (OR 0.43, 95% CI 0.21-0.88, p=0.02) but not bronchoscopic interventions (OR 0.78, 95% CI 0.45-1.35, p=0.37). Complication rates were similar across all interventions. Conclusion: BAE appears to be the most effective urgent interventional approach for massive hemoptysis, with a higher success rate and lower mortality compared to surgery. Bronchoscopic interventions may be considered in selected cases. Further research is needed to compare different BAE techniques and optimize patient selection.

The Efficacy of Antimalarial Therapy in the Treatment of Pulmonary Malaria: A Meta-Analysis Nalia Maharani AP; Dewi Wahyu Fitrina; Fenty Anggrainy
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 5 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i5.1277

Background: Pulmonary malaria, a severe form of malaria that affects the lungs, is associated with high mortality rates. Antimalarial therapy is the cornerstone of treatment, but the optimal regimen remains a subject of debate. This meta-analysis aimed to evaluate the efficacy of different antimalarial therapies in the treatment of pulmonary malaria. Methods: A systematic search of electronic databases (PubMed, Embase, Cochrane Library, and Web of Science) was conducted to identify randomized controlled trials (RCTs) comparing different antimalarial therapies for pulmonary malaria. The primary outcome was mortality. Secondary outcomes included parasite clearance time, respiratory distress resolution, and length of hospital stay. Pooled risk ratios (RRs) with 95% confidence intervals (CIs) were calculated using a random-effects model. Results: Seven RCTs met the inclusion criteria, enrolling a total of 1,245 patients with pulmonary malaria. The studies compared various antimalarial regimens, including artemisinin-based combination therapy (ACT), quinine, and artesunate. The meta-analysis showed that ACT was associated with a significantly lower risk of mortality compared to quinine (RR 0.67, 95% CI 0.52-0.86, p = 0.002). There was no significant difference in mortality between ACT and artesunate (RR 0.92, 95% CI 0.75-1.13, p = 0.43). ACT was also associated with a faster parasite clearance time and quicker resolution of respiratory distress compared to quinine. Conclusion: ACT is an effective treatment for pulmonary malaria, associated with reduced mortality and improved clinical outcomes compared to quinine. There was no significant difference in efficacy between ACT and artesunate. These findings support the use of ACT as the preferred antimalarial regimen for patients with pulmonary malaria.

Massive Hemoptysis: A Meta-Analysis of Urgent Interventional Approaches Bambang Rojullun Taufik; Russilawati; Dewi Wahyu Fitrina
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 5 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i5.1272

Background: Massive hemoptysis is a life-threatening medical emergency requiring immediate intervention. This meta-analysis evaluated the efficacy and safety of urgent interventional approaches for managing massive hemoptysis. Methods: A systematic search of electronic databases (PubMed, Embase, Scopus) was conducted from January 2013 to February 2024. Studies comparing different urgent interventional approaches (bronchial artery embolization [BAE], bronchoscopic interventions, surgery) in adults with massive hemoptysis were included. The primary outcome was treatment success (cessation of bleeding). Secondary outcomes included mortality, complications, and length of hospital stay. Results: Nine studies (n=1145 patients) were included. BAE was the most common intervention (7 studies), followed by bronchoscopic interventions (4 studies) and surgery (3 studies). Pooled analysis showed that BAE had a higher success rate compared to bronchoscopic interventions (OR 2.15, 95% CI 1.32-3.51, p=0.002) and surgery (OR 1.88, 95% CI 1.15-3.08, p=0.01). BAE was associated with a lower mortality rate compared to surgery (OR 0.43, 95% CI 0.21-0.88, p=0.02) but not bronchoscopic interventions (OR 0.78, 95% CI 0.45-1.35, p=0.37). Complication rates were similar across all interventions. Conclusion: BAE appears to be the most effective urgent interventional approach for massive hemoptysis, with a higher success rate and lower mortality compared to surgery. Bronchoscopic interventions may be considered in selected cases. Further research is needed to compare different BAE techniques and optimize patient selection.

The Efficacy of Antimalarial Therapy in the Treatment of Pulmonary Malaria: A Meta-Analysis Nalia Maharani AP; Dewi Wahyu Fitrina; Fenty Anggrainy
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 5 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i5.1277

Background: Pulmonary malaria, a severe form of malaria that affects the lungs, is associated with high mortality rates. Antimalarial therapy is the cornerstone of treatment, but the optimal regimen remains a subject of debate. This meta-analysis aimed to evaluate the efficacy of different antimalarial therapies in the treatment of pulmonary malaria. Methods: A systematic search of electronic databases (PubMed, Embase, Cochrane Library, and Web of Science) was conducted to identify randomized controlled trials (RCTs) comparing different antimalarial therapies for pulmonary malaria. The primary outcome was mortality. Secondary outcomes included parasite clearance time, respiratory distress resolution, and length of hospital stay. Pooled risk ratios (RRs) with 95% confidence intervals (CIs) were calculated using a random-effects model. Results: Seven RCTs met the inclusion criteria, enrolling a total of 1,245 patients with pulmonary malaria. The studies compared various antimalarial regimens, including artemisinin-based combination therapy (ACT), quinine, and artesunate. The meta-analysis showed that ACT was associated with a significantly lower risk of mortality compared to quinine (RR 0.67, 95% CI 0.52-0.86, p = 0.002). There was no significant difference in mortality between ACT and artesunate (RR 0.92, 95% CI 0.75-1.13, p = 0.43). ACT was also associated with a faster parasite clearance time and quicker resolution of respiratory distress compared to quinine. Conclusion: ACT is an effective treatment for pulmonary malaria, associated with reduced mortality and improved clinical outcomes compared to quinine. There was no significant difference in efficacy between ACT and artesunate. These findings support the use of ACT as the preferred antimalarial regimen for patients with pulmonary malaria.

Aspergilloma Mimicry of Lung Cancer: A Case Report Bagus HS, Muhammad; Irvan Medison; Dewi Wahyu Fitrina; Dessy Mizarti
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 7 (2024): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v8i7.1018

Background: Aspergilloma and lung cancer have similar risk factors, clinical features, and supporting features. Special supporting examinations are needed to rule out the differential diagnosis of aspergilloma. Case presentation: A 52-year-old male patient with coughing up blood and risk factors for smoking had a chest X-ray and computed tomography scan (CT scan) of the thorax and found a picture of a lung tumor. Bronchoscopy was carried out, and a bronchial lavage culture was carried out for the impression of Aspergillosis, given 1x150 mg of fluconazole for 6 months with improved clinical results and chest radiographs as well as negative sputum culture results. Conclusion: This patient showed the condition of aspergilloma mimicking lung cancer.

Aspergilloma Mimicry of Lung Cancer: A Case Report Bagus HS, Muhammad; Irvan Medison; Dewi Wahyu Fitrina; Dessy Mizarti
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 7 (2024): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v8i7.1018

Background: Aspergilloma and lung cancer have similar risk factors, clinical features, and supporting features. Special supporting examinations are needed to rule out the differential diagnosis of aspergilloma. Case presentation: A 52-year-old male patient with coughing up blood and risk factors for smoking had a chest X-ray and computed tomography scan (CT scan) of the thorax and found a picture of a lung tumor. Bronchoscopy was carried out, and a bronchial lavage culture was carried out for the impression of Aspergillosis, given 1x150 mg of fluconazole for 6 months with improved clinical results and chest radiographs as well as negative sputum culture results. Conclusion: This patient showed the condition of aspergilloma mimicking lung cancer.

Leukopenia as a Prognostic Factor in Severe Community-Acquired Pneumonia with Sepsis: A Case Report Irawan, Dandy; Irvan Medison; Dewi Wahyu Fitrina; Dessy Mizarti
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 12 (2024): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v8i12.1149

Background: Community-acquired pneumonia (CAP) is a major cause of sepsis, and severe CAP with sepsis is associated with significant morbidity and mortality. Leukopenia, a decrease in white blood cell count, has been identified as a potential prognostic factor in sepsis, suggesting a poorer outcome. This case report aims to evaluate the role of leukopenia in predicting the clinical course and outcome of a patient with severe CAP and sepsis. Case presentation: A 73-year-old male presented with complaints of shortness of breath, cough, fever, and altered mental status. He was diagnosed with severe CAP with sepsis and sepsis-associated encephalopathy (SAE). Laboratory investigations revealed leukopenia. The patient's clinical condition improved over 10 days of treatment, coinciding with an improvement in his white blood cell count. Conclusion: This case report highlights the potential prognostic value of leukopenia in patients with severe CAP and sepsis. The patient's clinical improvement paralleled the recovery of his white blood cell count, suggesting that leukopenia may serve as a marker of disease severity and treatment response. Further studies are needed to validate these findings and establish the role of leukopenia in the management of severe CAP with sepsis.

Pleural Amebiasis Mimicking Pleural Effusion: A Case Report Sari Handayani Utami; Irvan Medison; Dewi Wahyu Fitrina; Dessy Mizarti
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 1 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i1.1168

Background: Pleural amebiasis is a rare manifestation of extraintestinal amebiasis, primarily occurring due to the rupture of an amebic liver abscess into the pleural space. We present an unusual case of pleural amebiasis in an elderly woman without any evidence of liver involvement. Case presentation: A 78-year-old female presented with a two-month history of progressive dyspnea, cough, and right-sided chest pain. She had a history of consuming raw vegetables. Examination revealed right-sided pleural effusion, which was confirmed by chest radiography and thoracic ultrasound. Pleural fluid analysis showed exudative effusion and microscopic examination demonstrated the presence of Entamoeba histolytica trophozoites. Despite the absence of a liver abscess on abdominal ultrasound, the patient was diagnosed with pleural amebiasis based on the pleural fluid findings. She was successfully treated with metronidazole and drainage of the pleural fluid. Conclusion: This case highlights the importance of considering pleural amebiasis as a differential diagnosis in patients with pleural effusion, even in the absence of liver involvement. Early diagnosis and prompt treatment with metronidazole and drainage are crucial for a favorable outcome.

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