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All Journal Journal of Agromedicine and Medical Sciences Jurnal Kesehatan Tambusai
Navadz, Eqiel
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Dentistry Health Professions Medicine & Pharmacology Nursing Public Health

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LARGE IMMUNOLOGICAL CEREBRAL VASCULITIS, ENCEPHALITIS, AND MULTIPLE INFARCTION CAUSED BY MYCOBACTERIUM TUBERCULOSIS INFECTION IN YOUNG ADULTS : A RARE COMPLICATION OF TUBERCULOSIS) Navadz, Eqiel; Handoko, Eko Aprilianto; Taufiq, Kamilka; Sari, Putri Fortuna
Jurnal Kesehatan Tambusai Vol. 6 No. 2 (2025): JUNI 2025
Publisher : Universitas Pahlawan Tuanku Tambusai

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31004/jkt.v6i2.46999

Abstract

Tuberkulosis Neurovaskular-serebral adalah kondisi yang jarang terjadi, ditemukan pada sekitar 1% dari total kasus komplikasi tuberkulosis. Infeksi ini dapat menyebabkan vaskulitis serebral tidak hanya melalui invasi langsung, tetapi juga melalui deposisi kompleks imun. Kasus ini menjelaskan tentang vaskulitis serebral luas dan infark yang disebabkan oleh tuberkulosis pada dewasa muda. Seorang wanita muda berusia 21 tahun datang ke unit gawat darurat dengan keluhan bicara tidak jelas sejak satu hari sebelumnya. Pasien menggigil dan tidak merespons saat diajak berbicara. Pemeriksaan fisik menunjukkan tekanan darah 101/65 mmHg, nadi 80x/menit, suhu 36,7°C, dan saturasi oksigen (SpO2) 97%. Pemeriksaan neurologis menunjukkan GCS 456, tanda meningeal (+). Pemeriksaan laboratorium awal menunjukkan Hb 9,6 g/dl; HCT 29,8%; neutrofil 84,9%, limfosit 7%, SGOT 29 U/L, SGPT 51 U/L. Pemeriksaan rontgen dada menunjukkan dugaan tuberkulosis milier paru. Pemeriksaan dahak menunjukkan hasil positif DNA MTB dan sensitif terhadap rifampisin. Pemeriksaan serologis HIV tidak menunjukkan kelainan. Hasil CT scan kepala dengan kontras menunjukkan infark multipel pada hemisfer bilateral dan nukleus lentiform bilateral dari korpus kalosum bilateral. Pasien didiagnosis dengan vaskulitis serebral luas, ensefalitis, dan infark multipel yang berhubungan dengan infeksi tuberkulosis. Pasien mendapat pengobatan FDC (fixed dose combination) untuk tuberkulosis, antikonvulsan, mecobalamin, PPI, dan steroid dosis tinggi. Kasus ini tergolong langka, terutama sebagai komplikasi tuberkulosis yang menyebabkan vaskulitis serebral luas dan ensefalitis pada pasien dewasa muda. Deteksi dini merupakan kunci penting dalam memberikan pengobatan yang tepat kepada pasien.
Ischemic Stroke Induced by Bee Sting in Agricultural Society – A Rare Complication of Bee Sting: A Case Report Navadz, Eqiel; Aprilianto Handoko, Eko; Taufiq, Kamilka; Gemawan, Taufiq; Hakiim, Arsyzilma; Handoko, Adelia; Fortuna Sari, Putri
Journal of Agromedicine and Medical Sciences Vol. 11 No. 2 (2025)
Publisher : Faculty of Medicine, Universitas Jember

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19184/ams.v11i2.53705

Abstract

Abstract Introduction: Ischemic stroke is one of the highest causes of morbidity and mortality. One of the factors that triggers ischemic stroke which is quite rare is a bee sting. Pathomechanism of this condition remain unclear. This case report will describe a rare complication of bee sting and discuss it from a pathomechanism perspective. Case Report: A 40-year old woman came to the emergency room at Dr. Koesnadi Bondowoso with the main complaint of weakness in the right face. Referral patients from community health centers. The patient's complaint occurred 7,5 hours ago after being stung by a bee on the middle finger of his left hand. Physical examination showed facial angioedema, edema of digiti manus III sinsitra, and others normal. On neurological examination, it was found: Parasis Nervus XII and VII sinistra UMN type and hemiparasis sinistra. Laboratory examination showed increased neutrophils (90.4%) and eosinophilia (0.1%). A non-contrast CT scan examination showed a hypodense lesion in the right hemisphere. The patient was given antiplatelet, antihistamin, and neuroprotectan. Discussion: One of the rare complications of bee stings is ishemic stroke. This occurs due to the toxin from bee stings which contain vasoactive, pro-inflammatory agents, thrombogenic peptides, thromboxane A2, and leukotrienes which trigger platelet aggregation and vasoconstriction. This condition can trigger trombus formation and lead to ischemic stroke. Medical personnel, especially neurologists, must be aware of pathomechanism from the quite rare complications of ischemic stroke induced by bee stings, especially in rural areas Keywords: Ischemic Stroke, Bee sting, rural area.
Co-Authors Aprilianto Handoko, Eko Arsyzilma Hakiim Fortuna Sari, Putri Handoko, Adelia Handoko, Eko Aprilianto Sari, Putri Fortuna Taufiq Gemawan Taufiq, Kamilka