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All Journal Medicinus : Jurnal Kedokteran Jurnal Kedokteran Meditek
Sasongko, Calvin
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Biochemistry, Genetics & Molecular Biology Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Severe Leptospirosis (Weil’s Disease) Complicated by Septic Shock: A Case Report Andrean, Melvin; Sasongko, Calvin; Nabil Mubtadi Falah
Jurnal Kedokteran Meditek Vol 31 No 5 (2025): SEPTEMBER
Publisher : Fakultas Kedokteran Universitas Kristen Krida Wacana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36452/jkdoktmeditek.v31i5.3908

Abstract

Introduction: Weil’s disease is the severe manifestation of leptospirosis, characterized by multiorgan dysfunction and high mortality risk without timely diagnosis and treatment. Early clinical suspicion and prompt intervention are critical for favorable outcomes. Case Illustration: a 51-year-old male with fever, left leg myalgia, jaundice, hypotension, and tachycardia consistent with septic shock. Laboratory evaluation revealed leukocytosis, acute liver injury, and severe acute kidney injury. Additionally, chest imaging revealed bilateral pulmonary infiltrates. Initial management included fluid resuscitation, vasopressors, and broad-spectrum antibiotics. Leptospira IgM serology confirmed the presence of leptospirosis on day 2. Despite severe acute kidney injury, renal function improved without dialysis, and vasopressors were discontinued by day 3. The patient was discharged on day 11, having made a full recovery. Discussion: Severe leptospirosis can present with nonspecific symptoms and progress to septic shock and multiorgan dysfunction. In this case, the diagnosis was supported by IgM-ELISA and a history of exposure to floodwater. Early treatment with broad-spectrum antibiotics and supportive care led to a full recovery. Conclusion: This case highlights the uncommon presentation of septic shock as the dominant feature of Weil’s disease, together with rapid renal recovery without dialysis, underscoring the reversibility of multiorgan dysfunction when promptly managed.
Investigating the Prognostic Value of Serum Albumin Levels in Patients Undergoing Hemodialysis: A Systematic Review and Meta-analysis Adrya, Jessica; Sasongko, Calvin; Andrean, Melvin; Kartadinata, Muhammad Faishal; Theis, Aveline Maisie; Putri, Syafira Ayudiah Syah; Mukti, A. Muh. Yasser; Moelyadi, Felly; Varsha, Srigita; Dhika, Veriantara Satya
Medicinus Vol. 15 No. 1 (2025): October
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v15i1.10770

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Background: Hypoalbuminemia, characterized by low serum albumin levels, is frequently observed in patients undergoing hemodialysis and has been identified as a potential predictor of increased mortality risk. This systematic review aims to evaluate the relationship between hypoalbuminemia and mortality in hemodialysis patients, assessing the prognostic value of serum albumin levels as an indicator for patient outcomes. Methods: A comprehensive search was conducted in databases including PubMed, Europe PMC, and Scopus to identify relevant studies. Studies were included if they investigated the association between serum albumin levels and mortality outcomes in adult patients undergoing hemodialysis. Data extraction was performed independently by two reviewers, focusing on study characteristics, patient demographics, albumin levels, and mortality outcomes. Quality assessment of studies was conducted using the Newcastle-Ottawa Scale (NOS). Result: A total of eight studies, encompassing 45,178 hemodialysis patients with a mean age in the 50s, met the inclusion criteria. The studies had a combined male cohort of 22,501 individuals. The definition of hypoalbuminemia varied across studies, with cutoff values ranging from 3.0 to 3.9 g/dL. Follow-up durations spanned from as early as 3 months to a maximum of 6.1 years. The meta-analysis revealed a pooled hazard ratio (HR) of 1.08 (95% CI: 0.94–1.25), suggesting a non-significant association between hypoalbuminemia and increased mortality risk (P = 0.28). However, substantial heterogeneity was present (I² = 79%), indicating variability across studies. Conclusions: Hypoalbuminemia showed a non-significant association with mortality in hemodialysis patients, though variability across studies suggests further research is needed for clarity.
Co-Authors Adrya, Jessica Andrean, Melvin Dhika, Veriantara Satya Kartadinata, Muhammad Faishal Moelyadi, Felly Mukti, A. Muh. Yasser Nabil Mubtadi Falah Putri, Syafira Ayudiah Syah Theis, Aveline Maisie Varsha, Srigita