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All Journal Syntax Literate: Jurnal Ilmiah Indonesia Jurnal Penyakit Dalam Indonesia
Nugraha, Putu Arya
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Humanities Education Environmental Science Law, Crime, Criminology & Criminal Justice Medicine & Pharmacology Social Sciences Other

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Manifestasi Klinis Infeksi Mpox pada Penderita HIV: Sebuah Telaah Sistematik dan Meta-Analisis Mardaningrat, Gede Ari Mahendra; Nugraha, Putu Arya; Putri, Isabella Soerjanto; Aryadi, Putu Hendri
Jurnal Penyakit Dalam Indonesia Vol. 11, No. 2
Publisher : UI Scholars Hub

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Introduction. Mpox is a zoonotic disease caused by the mpox virus. Sexual intercourse is the biggest cause of mpox transmission. Human immunodeficiency virus (HIV) is a viral infection that is also transmitted mostly through sexual routes. This systematic review and meta-analysis was conducted to understand the clinical picture of mpox in relation to HIV infection. Methods. This meta-analysis followed MOOSE (Meta-analysis of Observational Studies in Epidemiology) guidelines. A systematic search for relevant studies was carried out using the PubMed, EMBASE and Cochrane Library databases covering the period 1 January 2022 to 31 May 2024. The keywords used were “Clinical feature” or “Clinical Manifestation” and “MPOX” or Monkey pox and “HIV”. Results. There were 8 studies that met the inclusion and exclusion criteria for meta-analysis. Eight studies were identified with a total of 2,392 patients with and without HIV. In this meta-analysis, an analysis of each clinical manifestation appearing in patients was conducted, resulting in statistically significant findings, including lymphadenopathy (RR: 0.89; 95% CI: 0.82-0.96), perianal lesions (RR: 1.17; 95% CI: 1.01-1.37), proctitis (RR: 1.79; 95% CI: 1.37-2.35), rectal pain (RR: 1.33; 95% CI: 1.16-1.52), rectal bleeding (RR: 1.33; 95% CI: 1.16-1.52), and tenesmus (RR: 1.63; 95% CI: 1.34-1.99). Conclusions. Enlarged lymph nodes, perianal lesions, proctitis, rectal pain, rectal bleeding, and tenesmus are the dominant clinical manifestations in mpox patients accompanied by HIV infection.
Pit Viper Venom-Induced Coagulopathy: Mandatory Antivenom, Avoidance of Anticoagulants, and Selective Transfusion Indrayani, Made; Andriyasa, I Ketut; Nugraha, Putu Arya; Widiastika, Made; Kluniari, Ni Made Nova Andari
Syntax Literate Jurnal Ilmiah Indonesia
Publisher : Syntax Corporation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36418/syntax-literate.v10i12.62728

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Venom-induced consumption coagulopathy (VICC) is a life-threatening complication following pit viper bites and remains a significant health concern in Southeast Asia. VICC has a distinct pathophysiology compared to typical disseminated intravascular coagulation (DIC), requiring a tailored management approach. This case highlights the successful treatment of severe VICC following a red-tailed green viper bite. A 64-year-old woman presented with left hand swelling three days after a red-tailed green viper bite to the wrist. She also had vomiting and fever on first day. She was alert and hemodynamically stable. Laboratory tests revealed severe thrombocytopenia (50 x 10³/μL), markedly elevated D-dimer (>10,000 ng/mL), and prolonged coagulation times. Complications included acute kidney injury, elevated liver enzymes, and gross hematuria. She received an initial dose of 2 vials of antivenom with close monitoring. As her coagulopathy progressed, additional antivenom was administered every 8 hours. Her condition began improving on day five without requiring blood transfusion. Unlike typical DIC, VICC should be managed primarily with antivenom, which neutralizes circulating venom and halts further coagulopathy. Anticoagulants are contraindicated, as pit viper venom contains both procoagulant and anticoagulant components that can worsen bleeding. The use of blood products in VICC is selective and symptom-based. Fresh frozen plasma (FFP) may be considered in patients with active bleeding or severe coagulopathy, thrombocyte concentrate (TC) is indicated if thrombocytopenia persists despite adequate antivenom, and packed red cells (PRC) are reserved for life-threatening anemia. VICC is a distinct coagulopathy requiring prompt antivenom administration, careful avoidance of anticoagulants, and judicious use of transfusions.
Co-Authors Andriyasa, I Ketut Aryadi, Putu Hendri Indrayani, Made Kluniari, Ni Made Nova Andari Mardaningrat, Gede Ari Mahendra Putri, Isabella Soerjanto Widiastika, Made