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All Journal Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI)
Harahap, Roni Ananda Perwira
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Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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Graves’ Disease and Subdural Empyema Due to Pansinusitis: Case Report Harahap, Roni Ananda Perwira; Melati Silvanni
Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI) Vol. 4 No. 3 (2022): Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI)
Publisher : TALENTA Publisher, Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/jetromi.v4i3.12735

Abstract

Background: Graves' disease is an autoimmune disease that primarily affects the thyroid gland. It may also affect multiple other organs including eyes and skin. Brain abscess and subdural empyema are serious infections that can stem from chronic suppurative diseases, congenital cardiomyopathy, consequences of head injury, or neurosurgical intervention, but the most frequently from chronic sinusitis or otitis. Case Presentation: A woman, age 22 years old, unmarried, came to the hospital with the main complaint of persistent headaches. Headache since 2 weeks ago along with fever that disappears arises without seizures. There is a lump in the neck for 3 years, and it has grown larger measuring 1x3 cm, immobile and supple. Nausea, vomiting, and decreased appetite are found. Thyroid fungtion test FT4 7.52 (0.93-1.7) ng/dL and TSH 0.01 (0.270-4.20) mIU/L. Chest X-ray: Dextrocardia and Cardiomegaly; MSCT Scan Head/Brain: conclusion: Pansinusitis and Right &; Left Mastoiditis; Ultrasound: thyroid: bilateral diffuse struma. MRI of the BRAIN with IV contrast: illustrating the subdural empyema. Treatment: Meropenem injection 2 g/24 hours, Dexamethasone injection 5mg/8 hours, Amitriptyline 2x12.5 mg, Thiamazole 1 x 20 mg, Propranolol 2 x 10 mg, PCT 3x1000 mg with pain scale monitoring. Conclusion: After being treated at the hospital for 8 days, complaints of headache began to decrease, and if the general condition was stable, the patient would be planned for a craniotomy with evacuation of an abscess in the brain.
Analysis of Differences in Germ Patterns in Pus Culture and Tissue Culture Examination in Patients with Diabetic Foot Ulcers at H. Adam Malik General Hospital, Medan Harahap, Roni Ananda Perwira; Ginting, Franciscus; Sihotang, Lenni Evalena
Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI) Vol. 7 No. 4 (2025): Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI)
Publisher : TALENTA Publisher, Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/jetromi.v7i4.20207

Abstract

Background: Diabetic foot ulcer (DFU) is one of the chronic complications of diabetes mellitus that can increase the risk of amputation and lead to high treatment costs if the infection is not properly managed. Identifying the etiology of the infection is crucial for determining effective treatment. However, in Indonesia, particularly at H. Adam Malik General Hospital in Medan, there has been no clear study focusing on identifying diabetic foot infection patterns based on tissue culture. The Infectious Diseases Society of America (IDSA) 2023 recommends using tissue culture techniques for bacterial identification, moving away from pus cultures. Objective: This study aims to analyze the differences in infection patterns obtained through pus culture and tissue culture in patients with diabetic foot ulcers. Methods: This prospective descriptive study involved 41 patients treated at H. Adam Malik General Hospital, Medan. Ulcer samples were collected using two methods: sterile swabs for pus culture and tissue samples for tissue culture. The culture results were analyzed using the Kruskal-Wallis statistical test to compare the differences in bacterial patterns. Results: Gram-negative bacteria dominated both culture methods, with Pseudomonas spp being the most common in pus cultures and Escherichia coli in tissue cultures. A significant difference was found between the two methods in bacterial identification (p < 0.05).Conclusion: There is a significant difference between tissue culture and pus culture in diabetic foot ulcers, particularly in the number and types of bacterial isolates, with a p-value of 0.002. This difference is not coincidental, supporting IDSA’s recommendation to prioritize tissue culture over swab culture. These findings are consistent with other studies in the field.
Co-Authors Ginting, Franciscus Melati Silvanni Sihotang, Lenni Evalena