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All Journal International Islamic Medical Journal JIMKI: Jurnal Ilmiah Mahasiswa Kedokteran Indonesia
Kamila, Muthia Dwifitri
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Religion Humanities Health Professions Medicine & Pharmacology Public Health

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Anemia Gravis Caused by Chronic Multiple Infection of Helminthiasis on Geriatric: An Evidence-Based Case Report Trasia, Reqgi First; Dua, Muhammad Yugo Hario Sakti; Desyana, Rizqia Meta Fairuz; Akmaluddin, Muhammad; Kamila, Muthia Dwifitri
Jurnal Medis Islam Internasional Vol 7 No 1 (2025): June
Publisher : UNUSA Press

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33086/iimj.v7i1.6629

Abstract

Introduction: Soil-transmitted helminth (STH) infections remain the most prevalent parasitic diseases globally. In elderly individuals, such infections can lead to significant morbidity, including anemia, fatigue, decreased activity levels, cognitive impairment, nutritional deficiencies, and gastrointestinal disturbances. This case report aims to highlight a rare instance of severe anemia caused by worm infestation in an elderly patient. Case: A 57-year-old male presented with a 7-day history of fatigue, dizziness, and marked pallor, accompanied by worsening abdominal pain over the past 5 days. Physical examination revealed moderate illness with pale conjunctiva, a mildly distended abdomen, and hyperactive bowel sounds. Laboratory tests showed a significant drop in hemoglobin, hematocrit, erythrocyte count, serum iron, TIBC, and ferritin levels. Endoscopic evaluation revealed esophagitis, a Forrest III gastric ulcer, and multiple worms in the duodenum, later identified macroscopically as Ascaris lumbricoides. Discussion: Worm infection is the most recent known diagnosis. The patient has undergone a complete stool analysis, but no worm eggs were found microscopically. This condition is very likely a false negative due to various factors, such as a less fresh stool sample (not examined immediately within 30 minutes) and human error by the analyst. The diagnosis was made after an endoscopic examination and multiple worms were found in the duodenum. When viewed from the large number of worms, it is likely that the patient has a severe and chronic worm infection. This is what causes the patient to suffer from anemia gravis with Hb 5.9. Conclusions: Initial clinical and laboratory assessments led to a diagnosis of anemia gravis. The patient received three units of packed red cells. Further investigations confirmed microcytic hypochromic anemia due to iron deficiency and chronic inflammation, with parasitic infection as the underlying cause. Treatment with a single 400 mg dose of albendazole resulted in clinical improvement, allowing for safe discharge.
Dugaan Massa Paru pada Kasus Pneumonia Berulang: CT Scan Memperlihatkan Bronkiektasis Yuarsa, Tri Agus; Kamila, Muthia Dwifitri; Fairuz Desyana, Rizqia Meta; Gayatri, Alya Indah; Nauli, Ghaniyyah; Laelatus Sifa, Silvia; Akmaluddin, Muhamad; Dwifitri Kamila, Muthia
JIMKI: Jurnal Ilmiah Mahasiswa Kedokteran Indonesia Vol 12 No 2 (2025): JIMKI: Jurnal Ilmiah Mahasiswa Kedokteran Indonesia Vol. 12.2 (2025)
Publisher : BAPIN-ISMKI (Badan Analisis Pengembangan Ilmiah Nasional - Ikatan Senat Mahasiswa Kedokteran Indonesia)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53366/jimki.v12i2.998

Abstract

Pendahuluan: Gambaran massa pada paru sering menimbulkan kecurigaan keganasan, terutama pada pasien dengan pneumonia berulang atau gejala respirasi persisten. Namun, beberapa kelainan non-neoplastik dapat menyerupai lesi massa secara radiologis. Ilustrasi Kasus: Seorang pria 61 tahun datang dengan dispnea memberat satu hari, disertai batuk produktif berwarna hijau kekuningan selama satu tahun. Pemeriksaan fisik menunjukkan penggunaan otot bantu napas, penurunan suara napas di paru kiri bawah, dan ronki bilateral. Saturasi oksigen 67% meningkat menjadi 98% dengan oksigen 15 L/menit melalui masker non-rebreathing. Laboratorium menunjukkan leukositosis (31,5×10³/µL), anemia, serta peningkatan urea; hasil TCM TB dan HIV negatif. Foto toraks menunjukkan fibrosis paru kanan dan opasitas di lapang paru kiri bawah. CT toraks dengan kontras memperlihatkan bronkiektasis dengan penebalan dinding bronkus, lesi hipodens berdinding tebal di lobus atas kiri, serta pola tree-in-bud di lobus bawah—menyingkirkan dugaan massa paru. Diagnosis kerja adalah bronkiektasis dengan pneumonia, dengan pertimbangan diferensial tuberkulosis paru. Pasien mendapat Seftriakson, Levofloksasin, terapi antituberkulosis, dan oksigen dengan perbaikan klinis bertahap. Diskusi: Pneumonia dapat menimbulkan konsolidasi lobar akibat eksudasi alveolar yang menyerupai keganasan. Pada kasus ini, CT menunjukkan dilatasi bronkus irreversibel menandakan bronkiektasis kronik. Di wilayah endemis TB, bronkiektasis pasca-TB merupakan penyebab tersering. HRCT menjadi standar emas membedakan bronkiektasis dari pneumonia atau lesi neoplastik, dengan pola signet-ring dan honeycomb sebagai temuan khas. Simpulan: CT toraks berperan penting membedakan infeksi paru kronik dari neoplasma, mencegah salah diagnosis dan terapi yang tidak tepat.
Co-Authors Akmaluddin, Muhamad Akmaluddin, Muhammad Desyana, Rizqia Meta Fairuz Dua, Muhammad Yugo Hario Sakti Dwifitri Kamila, Muthia Fairuz Desyana, Rizqia Meta Gayatri, Alya Indah Laelatus Sifa, Silvia Nauli, Ghaniyyah Reqgi First Trasia Yuarsa, Tri Agus