Embun Manja Sari
Universitas Padjadjaran

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Faktor risiko dan tatalaksana kandidiasis oral pada pasien dengan drug reaction with eosinophilia and systemic symptoms (DRESS)Risk factors and management of oral candidiasis in drug reaction with eosinophilia and systemic symptoms (DRESS) patients Embun Manja Sari; Nuri Fitriasari; Nanan Nur'aeny
Jurnal Kedokteran Gigi Universitas Padjadjaran Vol 34, No 1 (2022): April 2022
Publisher : Fakultas Kedokteran Gigi Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/jkg.v34i1.33531

Abstract

Pendahuluan: Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) adalah reaksi obat yang jarang terjadi, tetapi menimbulkan reaksi klinis yang berat, berupa demam, erupsi kulit, dan keterlibatan organ internal. Terapi medikasi untuk pasien DRESS berupa pemberian kortikosteroid high potent memiliki faktor risiko terjadinya kandidiasis oral selain faktor gangguan imunitas secara sistemik akibat DRESS. Penulisan laporan kasus bertujuan untuk memaparkan faktor risiko dan tatalaksana kandidiasis oral pada pasien DRESS. Laporan kasus: Seorang laki-laki berusia 51 tahun dirawat selama 14 hari dengan diagnosis DRESS oleh bagian Dermatologi dan Venereologi Rumah Sakit Hasan Sadikin Bandung. Terapi intravena yang diberikan adalah Deksametason 20 gram/hari, Vitamin K 3x1 ampul/hari, Omeprazole 1x40 gram/hari, dan Siprofloksasin 2x400 gram/hari. Terapi per oral yang diberikan adalah: Cetirizine 1x10 gram/hari, Curcuma 3x1 kapsul/hari, Asam folat 1x1 tab/hari, Asetilsistein 2x2 mg/hari, serta Callos 1x500 mg/hari. Pasien kemudian dikonsulkan ke bagian Ilmu Penyakit Mulut karena memiliki keluhan sakit pada rongga mulut, tenggorokan, dan bibir sejak 3 hari di RS. Riwayat sariawan berulang disangkal. Pasien tidak pernah menyikat gigi selama rawat inap. Tatalaksana kandidiasis oral diberikan Nystatin in oral suspension 4x200.000 IU/hari, Chlorhexidine digluconate 0,12%, asam hialuronat, NaCl 0,9%, serta Mikonazol krim 2% dan racikan deksametason salep 0,002% diberikan terkait lesi pada bibir dan dioleskan pada sudut mulut. Simpulan: Faktor risiko kandidiasis oral pada pasien DRESS adalah penggunaan kortikosteroid secara sistemik, gangguan imun terkait DRESS, dan kebersihan rongga mulut yang buruk. Tatalaksana kandidiasis oral diberikan adalah antifungal dan antiseptik.Kata kunci: drug reaction with eosinophilia and systemic symptoms; faktor risiko; kandidiasis oral ABSTRACTIntroduction: Drug reaction with eosinophilia and systemic symptoms (DRESS) is a rare drug reaction but causes severe clinical reactions in the form of fever, skin eruptions, and involvement of internal organs. Medical therapy for DRESS patients in the form of high potent corticosteroids has a risk factor for oral candidiasis and systemic immune disorders. This case report aimed to describe the risk factors and management of oral candidiasis in DRESS patients. Case report: A 51-year-old male was treated for 14 days with a diagnosis of DRESS by the Department of Dermatology and Venereology of Hasan Sadikin Hospital, Bandung. Intravenous therapy administered was 20 grams/day of Dexamethasone, 3x1 ampoules/day of Vitamin K, 1x40 grams/day of Omeprazole, and 2x400 grams/day of Ciprofloxacin. Oral therapy was 1x10 grams/day of Cetirizine, 3x1 capsules/day of Curcuma, 1x1 tab/day of folic acid, 2x2 mg/day of Acetylcysteine, and 1x500 mg/day of Callos. The patient was then referred to the Department of Oral Medicine because of complaints of pain in the oral cavity, throat, and lips after hospitalisation for three days. History of recurrent thrush was denied. The patient never brushed his teeth during hospitalisation. The management of oral candidiasis was the administration of Nystatin in oral suspension with the dose of 4x200,000 IU/day, 0.12% Chlorhexidine digluconate, hyaluronic acid, 0.9% NaCl, and 2% topical Miconazole,  and a mixture of 0.002% dexamethasone ointment, which was given related to lesions on the lips, and topically administered in the corner of the lips. Conclusion: The risk factors for oral candidiasis in DRESS patients are systemic use of corticosteroids, DRESS-related immune disorders, and poor oral hygiene. The management of oral candidiasis is antifungal and antiseptic.Keywords: drug reaction with eosinophilia and systemic symptoms; oral candidiasis, risk factors
MANIFESTASI ORAL TERKAIT IMMUNE RECONSTITUTION INFLAMMATORY SYNDROME PADA HUMAN IMMUNODEFICIENCY VIRUS/ ACQUIRED IMMUNODEFICIENCY SYNDROME Embun Manja Sari; Wahyu Hidayat
B-Dent: Jurnal Kedokteran Gigi Universitas Baiturrahmah Vol 9, No 2 (2022): Vol 9 No 2, Desember 2022
Publisher : Universitas Baiturrahmah

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33854/jbd.v9i2.1014

Abstract

Introduction: Treatment for Human Immunodeficiency Virus (HIV) infections using antiretroviral (ARV) resulting in varying stage response in the oral cavity. Some studies showed good responses but can also lead to Immune Reconstitution Inflammatory Syndrome (IRIS). IRIS is widely known as a complication of ARV therapy. Oral lesions in HIV / AIDS patients that emerge after taking ARV therapy can be categorized as IRIS cases. This systemic review aims to observe oral manifestations associated with IRIS. Review: Systematic review is carried out by the PRISMA method. The inclusion criteria are clinical trial articles collected from electronic searches, including full text through the PubMed portal, Research Gate, and Google Scholar using keywords: HIV / AIDS, IRIS, and oral manifestations which were published from 2011 to December 2019. A total of 6 articles were identified. The results showed that oral lesions in HIV/ AIDS related to IRIS are Kaposi Sarcoma 29.2%, OHL 16.9%, oral candidiasis 11.5%, and RAS 5.6%. The incidence of IRIS was around 10-27% in HIV / AIDS patients who have started ARV therapy. The incidence of IRIS is higher in prevalence in patients starting ARV therapy with low CD4 counts. Conclusion: Oral manifestations associated with IRIS in most HIV /AIDS patients are Kaposi's Sarcoma, OHL, Oral candidiasis, and SAR