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All Journal Media Karya Kesehatan Science Midwifery Journal of Clinical Microbiology and Infectious Diseases
Adi, Putu Dwi
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Dentistry Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health Veterinary

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Severe case of Streptococcus suis meningitis in Bali Mandara Hospital: a case report Saputra, I Wayan Agus Gede Manik; Triatmoko, Indira Chadijah; Widarmawan, I Gede Eka; Hermawan, I Gede; Adi, Putu Dwi
Journal of Clinical Microbiology and Infectious Diseases Vol. 3 No. 1 (2023): Available online : June 2023
Publisher : Indonesian Society for Clinical Microbiology (Perhimpunan Dokter Spesialis Mikrobiologi Klinik Indonesia)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/jcmid.v3i1.45

Abstract

Background: Streptococcus suis meningitis (SSM) is one of the zoonotic disease that can cause serious illness in humans.  The major risk factor in many cases of SSM is associated with pig husbandry and consuming undercooked pork products. In Indonesia, especially in Bali, the cases of this acute bacterial meningitis has been strongly correlated with consuming Balinese traditional food called “red lawar”, a mixture of raw pork, fresh pork blood and traditional Balinese herbs. This study aims to report a case of SSM in Bali Mandara Hospital. Case description: A 63-year-old man admitted to the Emergency Department because of a decrease in consciousness (Glasgow coma scale 3/15).  This patient was transferred from a private hospital with septic shock and suspicious to acute bacterial meningitis.  He  had other related  symptoms like fever, headache, and cough since two days prior to admission. He also had a history of consuming “red lawar” 2 days before the symptoms appeared.  Laboratory findings from cerebrospinal fluid analysis and septic marker indicate the patient had bacterial meningitis. The patient was initially started by Meropenem due to his septic shock.  The broad spectrum antibiotics were then de-escalate to Ceftriaxone once the culture and sensitivity test completed and yielded Streptococcus suis.  The course of Ceftriaxone as definitive therapy has been administered for 14 days and showed clinical improvement without specific sequelae related to SSM infection like hearing loss. Conclusion: Severe meningitis e.c Streptococcus suis leading to septic shock is a life threatening health condition. Adequate antibiotic therapy and multidisciplinary approach can reduce mortality and morbidity of this case.
Suspected chikungunya outbreak in Klungkung, Bali: Environmental and behavioral risk factors Widaryati, Ni Luh Rahayu; Widarini, Ni Putu; Adi, Putu Dwi
Science Midwifery Vol 14 No 1 (2026): April: Health Sciences and related fields
Publisher : Institute of Computer Science (IOCS)

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Chikungunya outbreaks in communities with no prior recorded transmission history remain poorly studied in Indonesia, where delayed case detection and low community health literacy present distinct epidemiological challenges. This study investigated a suspected chikungunya extraordinary event in Banjar Jumpai Kangin, Desa Jumpai, Kabupaten Klungkung, Bali, between April and May 2025, with the aim of describing the epidemiological characteristics of the outbreak and identifying the environmental and behavioral risk factors associated with transmission. A case-control design was employed, with data collected through structured interviews, direct environmental observation, and secondary data review. A total of 36 suspected cases were identified, peaking at 8 cases on 8 May 2025, with the majority being female (58.3%) and aged 5 to 14 years (33.3%). All cases presented with fever (100%), followed by arthralgia (91.7%) and rash (83.3%). Bivariate analysis identified four significant risk factors, including the absence of routine water storage container draining (p less than 0.001), the absence of mosquito nest eradication practices (p = 0.046), the presence of mosquito larvae in the household (p = 0.032), and the lack of personal protective behavior against mosquito bites (p = 0.018). Community knowledge of chikungunya was uniformly poor across both case and control groups. Delayed case reporting substantially prolonged the period before any public health response was initiated. These findings underscore the need for proactive community-based surveillance in areas with no prior chikungunya history, and support policy interventions targeting household vector control practices and health literacy as the primary levers for outbreak prevention.
Diphtheria Transmission Amid High Immunization Coverage Adnyani, Ni Kadek Mita Dwi; Subrata, I Made; Adi, Putu Dwi
Media Karya Kesehatan Vol 9, No 1 (2026): Media Karya Kesehatan
Publisher : Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/mkk.v9i1.67076

Abstract

Diphtheria is an infectious disease caused by Corynebacterium diphtheriae that can lead to various complications, including death in individuals with incomplete immunization status. The province of Bali, particularly Jembrana, is an area with high population mobility where diphtheria cases are rarely reported. However, in 2025, one suspected case of diphtheria was identified, necessitating an investigation to determine the source of transmission. The investigation was conducted as a descriptive observational study using a case study approach. Data were collected through field investigations, clinical examinations, and laboratory tests. Based on the investigation results, this was the first reported case in the past three years, occurring on March 13, 2025. The case occurred in Jembrana, the gateway to the island of Bali, which has high population mobility. The patient was a 7 year old boy with a complete immunization status; however, he had a history of close contact with family members who had recently returned from an area with a history of a diphtheria outbreak, making him a potential asymptomatic carrier. Laboratory testing using culture methods yielded negative results, likely due to delayed sample submission and reduced bacterial viability, preventing growth on the culture medium. Under these conditions, the RT-qPCR method has the potential to detect the presence of Corynebacterium diphtheriae DNA even when culture results are negative. Vaccination status acts as a protective factor, but does not completely prevent infection. The most significant factor in transmission is close contact with family members who have a history of travel to areas with diphtheria outbreaks, with the possible involvement of asymptomatic carriers. Management of suspected diphtheria cases requires the immediate administration of Anti-Diphtheria Serum (ADS). These findings underscore the need to strengthen active surveillance, regular monitoring, and public education to prevent an increase in cases.Keywords: Diphtheria, immunization, Corynebacterium diphtheriae, asymptomatic carrier.
Co-Authors Adnyani, Ni Kadek Mita Dwi I Gede Hermawan I Made Subrata, I Made Ni Putu Widarini Saputra, I Wayan Agus Gede Manik Triatmoko, Indira Chadijah Widarmawan, I Gede Eka Widaryati, Ni Luh Rahayu