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Emfisema Subkutis Derajat 5 pada Pasien Rekuren Pneumotoraks Spontan Sekunder : Sebuah Laporan Kasus Dwikarlina, Intan; Wijaya, Rendy; Antariksa, Genta; Sari, Fitri; Putra, Christian
Jurnal Klinik dan Riset Kesehatan Vol 3 No 1 (2023): Edisi Oktober
Publisher : RSUD Dr. Saiful Anwar Province of East Java

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/jk-risk.03.1.8

Abstract

Pendahuluan: Emfisema subkutis merupakan kondisi terdapatnya udara di lapisan subkutan kulit. Emfisema subkutis terjadi melalui berbagai etiologi, salah satunya yakni akibat pecahnya alveoli yang menyebabkan infiltrasi udara diantara jaringan ikat pada kasus pasien dengan pneumotoraks spontan. Laporan Kasus: Pria usia 53 tahun datang dengan keluhan sesak nafas yang muncul tiba-tiba setelah pasien BAB. Keluhan sesak disertai pembengkakan luas pada seluruh tubuh dimulai dari area genitalia hingga seluruh wajah pasien. Pasien memiliki riwayat pneumotoraks spontan sekunder dan memiliki riwayat menderita tuberkulosis yang kambuh pada tahun 2021. Diskusi: Emfisema subkutis terjadi ketika udara masuk ke jaringan di bawah kulit dan jaringan lunak. Emfisema subkutis dapat diklasifikasikan menjadi lima tingkatan berdasarkan tingkat keparahannya. Pada laporan kasus ini, emfisema subkutis derajat 5 terjadi karena riwayat pneumotoraks pada paru kanan pasien. Pneumotoraks bisa bersifat traumatik atau spontan. Pneumotoraks spontan bisa dibagi menjadi primer (tanpa penyebab yang jelas) atau sekunder (terkait dengan penyakit paru). Pasien juga memiliki riwayat penyakit tuberkulosis dan sindrom obstruksi pasca tuberkulosis (SOPT). Penanganan pasien meliputi pemasangan chest tube, terapi oksigen, dan tindakan dekompresi udara subkutan. Kesimpulan: Pada laporan kasus ini, emfisema subkutis derajat 5 dengan riwayat infeksi tuberkulosis berespon baik terhadap pemasangan chest tube tergambar dengan penurunan derajat emfisema secara bertahap. Tenaga medis diperlukan untuk melakukan anamnesis dan pemeriksaan medis secara holistik dan komprehensif terkait faktor resiko penyebab emfisema subkutis derajat 5.
Diagnosis dan Manajemen Obstruksi Jalan Napas Atas (Jackson 1) Akibat Infeksi Difteri pada Wanita Hamil Dwikarlina, Intan; Wijaya, Rendy; Yulia Rusmayanti, Mega; Antariksa, Genta; Candradikusuma, Didi
Jurnal Klinik dan Riset Kesehatan Vol 4 No 2 (2025): Edisi Februari
Publisher : RSUD Dr. Saiful Anwar Province of East Java

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/jk-risk.04.2.9

Abstract

Diphtheria is an infectious disease caused by Corynebacterium diphtheria, which generally causes inflammation of the airways, leading to severe symptoms that can be life-threatening. Indonesia is listed as one of the ten countries with the highest cases of diphtheria worldwide. However, studies on cases of diphtheria infection, especially in the pregnant women population, have rarely been reported. A 28-year-old woman presented with shortness of breath. Complaints accompanied by difficulty swallowing and speaking. The patient had a child who died due to similar symptoms. Signs of airway obstruction are found as inspiratory stridor and suprasternal retraction, pseudomembranes in the pharynx, and subcutaneous crepitation in the colli. Diphtheria infection was confirmed through a throat swab examination with Neisser staining and culture. In addition to isolation, the patients were administered oxygen therapy, anti-diphtheria toxin, penicillin procaine, dexamethasone, and additional supportive therapy. Diphtheria infection is transmitted through direct contact, droplets or contaminated items. Manifestations of laryngeal diphtheria generally come from the extension of tonsillar-pharyngeal diphtheria symptoms, including sore throat, hoarseness, and advanced respiratory obstruction. A definite diagnosis is made by isolating the bacteria or finding an increase in serum antibodies. Therapies targeting infectious conditions and supporting obstetrics help improve the overall patient condition. Diphtheria is a highly contagious and potentially fatal disease, especially for pregnant women; thus, immediate diagnosis is needed. Isolation and appropriate management alleviate upper airway obstruction. Diphtheria management should include both curative therapy and preventive to protect the community further and prevent outbreaks from emerging.
Catamenial Pneumothorax due to Suspected Thoracic Endometriosis Syndrome in a Woman with Adenomyosis and Cystoma Ovarii Antariksa, Genta; Dwikarlina, Intan; Sutrisno, Sutrisno; Yudhanto, Hendy Setyo
Jurnal Kedokteran Brawijaya Vol. 33 No. 3 (2025)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2025.033.03.10

Abstract

Catamenial pneumothorax (CP) is a recurrent spontaneous pneumothorax during the menstruation period and is often associated with thoracic-pelvic endometriosis. This case study reported a 39-year-old woman who presented with recurrent shortness of breath, particularly during menstruation. The patient also experienced severe dysmenorrhea and difficulty getting pregnant. Despite a negative sputum test, a history of chest tube insertion and tuberculosis treatment were identified. Elevated levels of the CA-125 marker were observed in a previous examination. Physical examination revealed decreased fremitus sounds on the mediobasal side, chest expansion, and right lung breath sounds. The plain radiograph displayed a visceral pleural line, air-fluid level appearance, and the collapse of the right hemithorax accompanied by fibrosis. The patient underwent inpatient treatment and had a chest tube inserted. A decortication thoracotomy procedure was performed, and anatomical pathology microscopic examination of the right lung tissue revealed a non-specific chronic inflammatory process accompanied by fibrosis.
Emfisema Subkutis Derajat 5 pada Pasien Rekuren Pneumotoraks Spontan Sekunder : Sebuah Laporan Kasus Sari, Fitri; Dwikarlina, Intan; Wijaya, Rendy; Antariksa, Genta; Sarti, Fitri; Putra, Christian
Jurnal Klinik dan Riset Kesehatan Vol 3 No 1 (2023): Edisi Oktober
Publisher : RSUD Dr. Saiful Anwar Province of East Java

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/jk-risk.03.1.8

Abstract

Background: Subcutaneous emphysema is a condition where persistent air exists in the subcutaneous layer of the skin. Subcutaneous emphysema occurs through various etiologies, one of which is due to the rupture of the alveoli that cause air infiltration between the connective tissues in patients with spontaneous pneumothorax. Case Presentation: A 53-year-old man complained of shortness of breath that appeared suddenly after the patient defecated. Complaints of chest tightness accompanied by extensive swelling throughout the body starting from the patient’s genital to the entire patient's face. The patient had a history of secondary spontaneous pneumothorax and a history of suffering from tuberculosis recurrence in 2021. Discussion: Subcutaneous emphysema occurs when air enters the tissues under the skin and soft tissues. Subcutaneous emphysema can be classified into five grades based on its severity. In this case report, grade 5 subcutaneous emphysema occurred because of a patient's right lung history of pneumothorax. Pneumothorax can be traumatic or spontaneous. Spontaneous pneumothorax can be divided into primary (without a clear cause) or secondary (associated with lung disease). The patient also has a history of tuberculosis and post-tuberculosis obstructive syndrome (SOPT). Patient management includes chest tube placement, oxygen therapy, and subcutaneous air decompression measures. Conclusion: In this case report, a grade 5 subcutaneous emphysema with a history of tuberculosis infection responded well to chest tube insertion as illustrated by the gradual reduction in emphysema degrees. Medical personnel is needed to carry out a holistic and comprehensive history and medical examination regarding the risk factors for grade 5 subcutaneous emphysema.
Diagnosis dan Manajemen Obstruksi Jalan Napas Atas (Jackson 1) Akibat Infeksi Difteri pada Wanita Hamil Dwikarlina, Intan; Wijaya, Rendy; Yulia Rusmayanti, Mega; Antariksa, Genta; Candradikusuma, Didi
Jurnal Klinik dan Riset Kesehatan Vol 4 No 2 (2025): Edisi Februari
Publisher : RSUD Dr. Saiful Anwar Province of East Java

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/jk-risk.04.2.9

Abstract

Diphtheria is an infectious disease caused by Corynebacterium diphtheria, which generally causes inflammation of the airways, leading to severe symptoms that can be life-threatening. Indonesia is listed as one of the ten countries with the highest cases of diphtheria worldwide. However, studies on cases of diphtheria infection, especially in the pregnant women population, have rarely been reported. A 28-year-old woman presented with shortness of breath. Complaints accompanied by difficulty swallowing and speaking. The patient had a child who died due to similar symptoms. Signs of airway obstruction are found as inspiratory stridor and suprasternal retraction, pseudomembranes in the pharynx, and subcutaneous crepitation in the colli. Diphtheria infection was confirmed through a throat swab examination with Neisser staining and culture. In addition to isolation, the patients were administered oxygen therapy, anti-diphtheria toxin, penicillin procaine, dexamethasone, and additional supportive therapy. Diphtheria infection is transmitted through direct contact, droplets or contaminated items. Manifestations of laryngeal diphtheria generally come from the extension of tonsillar-pharyngeal diphtheria symptoms, including sore throat, hoarseness, and advanced respiratory obstruction. A definite diagnosis is made by isolating the bacteria or finding an increase in serum antibodies. Therapies targeting infectious conditions and supporting obstetrics help improve the overall patient condition. Diphtheria is a highly contagious and potentially fatal disease, especially for pregnant women; thus, immediate diagnosis is needed. Isolation and appropriate management alleviate upper airway obstruction. Diphtheria management should include both curative therapy and preventive to protect the community further and prevent outbreaks from emerging.