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All Journal Medicinus : Jurnal Kedokteran Jurnal Health Sains Al Makki Health Informatics Journal
Putri, Hesti Andika
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Dentistry Health Professions Medicine & Pharmacology Nursing Public Health Veterinary

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Journal : Al Makki Health Informatics Journal

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HIV/AIDS Young Adult with Diabetes Mellitus Presenting with Newly Diagnosed Pulmonary Tuberculosis, Pneumonia Hypokalemia and Atrial Fibrillation : A Rare Case Report Putri, Hesti Andika; Febryan, Reza
Al Makki Health Informatics Journal Vol. 3 No. 4 (2025): Al Makki Health Informatics Journal
Publisher : Al Makki Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.57185/hij.v3i4.57

Abstract

Pneumonia, pulmonary tuberculosis (TB), Human Immunodeficiency Virus (HIV)/Acquired Immunodeficiency Syndrome (AIDS), and metabolic disorders such as diabetes mellitus (DM) represent complex clinical challenges, particularly in young adults. Hypokalemia and cardiac arrhythmias such as atrial fibrillation (AF) may further worsen the prognosis in these conditions. Recent studies have highlighted the association between TB, pneumonia, and AF, suggesting an increased risk of systemic inflammation and electrolyte disturbances. We report and analyze a rare case of a young male patient with a unique combination of HIV infection, diabetes mellitus, clinical pulmonary TB, pneumonia, hypokalemia, and atrial fibrillation. This is a descriptive case report study. Data were collected through history taking, physical examination, supporting investigations, and management during hospitalization. A 25-year-old male presented with shortness of breath for one day, a history of cough for more than three months, weight loss, fever, and a history of insulin use five years prior. Physical examination revealed pale conjunctiva and oral candidiasis; no other abnormalities were found. Laboratory tests showed hemoglobin 10.8 g/dL, leukocytes 8,280/µL, platelets 296,000/µL, MCV 89.4 fL, MCHC 33.9 g/dL, HbA1c 8.4%, potassium 2.7 mmol/L, lymphocytes 6.6%, and reactive results for HIV qualitative testing (R1, R2, R3). Electrocardiogram (ECG) showed atrial fibrillation with normal ventricular response. Chest X-ray revealed normal cardiac size and findings suggestive of bronchitis and suspected pneumonia. Thoracic CT scan with and without contrast demonstrated features consistent with pneumonia and multiple bilateral paratracheal and subcarinal lymphadenopathy. This case highlights the need for multidisciplinary management involving anesthesiology, pulmonology, internal medicine, cardiology, and pharmacy to ensure comprehensive care and optimize clinical outcomes, while preventing potentially fatal complications.
Co-Authors Amelia, Sesa Amly, Harzalina Zilfi Febryan, Reza Guantoro, Vincent Halim, Kurnia Heriawan, Timotius Ivan Jacobs, Christin Yosefin Mathlubaa, Asya