Muhammad Hafizhan
Neurology Department, Faculty of Medicine, Universitas Sebelas Maret, Surakarta, Indonesia

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PANCOAST TUMOR PRESENTING WITH HORNER SYNDROME: A CASE REPORT Raden Andi Ario Tedjo; Hillary Hillary; Vivienne Tjung; Stefanus Erdana Putra; Muhammad Hafizhan
MNJ (Malang Neurology Journal) Vol. 9 No. 2 (2023): July
Publisher : PERDOSSI (Perhimpunan Dokter Spesialis Saraf Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2023.009.02.18

Abstract

Case Report: A 50-year-old man was referred to Dr. Moewardi General Hospital with history of right chest pain that radiate to the right back and hand for 2 months. His complaint did not improve with medication and physical therapy. On physical examination we observed multiple nodules on the right axilla, scapula, and colli region. Neurological examination revealed right sided partial ptosis, anisocoria, ipsilateral weakness, and ipsilateral allodynia, and anhidrosis T1 dermatome. CT-scan showed a right lung mass in the superior lobe of the apical segment. The diagnosis of Horner syndrome is then established caused by multiple lymphadenopathies. His symptoms then relieved after lymphadenectomy. Conclusion: Horner syndrome, characterized by ipsilateral pupillary anisocoria, ptosis and anhidrosis, is one of the complications of Pancoast tumor invasion to the sympathetic nervous system in the C8, T1, and T2 nerve territory.
HUMAN HERPESVIRUS-6 MENINGOENCEPHALITIS AND PULMONARY TUBERCULOSIS IN HIV PATIENT: A CASE REPORT: Meningoensefalitis Human Herpesvirus-6 dan Tuberkulosis Paru pada Pasien HIV: Laporan Kasus Hanindia Riani Prabaningtyas; Stefanus Erdana Putra; Muhammad Hafizhan; Diah Kurnia Mirawati; Pepi Budianto
Biomedika Vol 15, No 1 (2023): Biomedika Februari 2023
Publisher : Universitas Muhammadiyah Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23917/biomedika.v15i1.1753

Abstract

ABSTRACT Human herpesvirus 6 (HHV-6), the causative agent of exanthema subitum in childhood, could also induce meningoencephalitis in immunocompromised individuals. We reported a case of 32-years-old woman with complaints of worsen headache, one week before admission. She also had intermittent fever and weakness in her left limb. She was admitted to a local hospital, suspected with tuberculous meningitis and pulmonary tuberculosis, and treated with anti-tuberculosis drugs, antibiotics for bacterial meningitis and steroids. She did not show any improvement, and then referred to X Surakarta General Hospital. On physical examination, we found GCS of E3V3M5, crackles and wheezing throughout the lung, neck stiffness, left hemiparesis, and clonus of the left lower leg. Laboratory results showed increasing leukocytes, reactive anti-HIV, and positive PCR for HHV-6 in the cerebrospinal fluid. On the CT scan, there were multiple hypodense lesions in the pons and right internal capsule, and communicant hydrocephalus. She was treated with highly active anti-retroviral therapy (HAART), Valganciclovir 900 mg b.i.d., steroid, anti-tuberculosis drugs and symptomatic treatment. After three weeks of admission, she began to show improvement, level of consciousness increased, and allowed went home. ABSTRAK Human herpesvirus-6 (HHV-6), agen penyebab eksantema subitum pada masa kanak-kanak, juga dapat menyebabkan meningoensefalitis pada individu dengan gangguan sistem imun. Kami melaporkan sebuah kasus, seorang wanita berusia 32 tahun dengan keluhan nyeri kepala yang semakin memberat sejak satu minggu sebelum masuk rumah sakit. Selain itu, pasien juga mengeluh demam intermiten dan kelemahan pada tungkai kiri. Pasien dirawat di rumah sakit lokal dengan diagnosis suspek meningitis tuberkulosis dan tuberkulosis paru dan ditatalaksana dengan obat anti tuberkulosis, antibiotik untuk meningitis bakteri dan steroid. Karena tidak ada perbaikan, pasien dirujuk ke RS X Surakarta. Pada pemeriksaan fisik ditemukan GCS E3V3M5, ronki dan mengi di seluruh lapang paru, kaku kuduk, hemiparesis kiri, dan klonus tungkai bawah kiri. Hasil laboratorium menunjukkan peningkatan leukosit, anti-HIV reaktif, dan PCR HHV-6 positif pada cairan serebrospinal. Pada CT-scan ditemukan lesi hipodens multipel pada pons dan capsula interna kanan serta hidrosefalus komunikan. Pasien ditatalaksana dengan highly active anti-retroviral therapy (HAART), Valgansiklovir 900mg/12 jam, steroid, obat anti tuberkulosis dan pengobatan simtomatik. Setelah perawatan selama tiga minggu, pasien mulai menunjukkan perbaikan, tingkat kesadaran meningkat, dan diperbolehkan pulang.