Sporotrikosis - Sitti Hajar (Universitas Syiah Kuala, 2006)
AbstrakLatar. belakang : Sporotrikosis disebabkan oleh jamur dimorfik Sporothrix schenckiiyang tersebar diselurub dunia. Sporotrikosis merupakan kasus yang jarang. Penanganan Sporotrikosis adalah sulit.Kasus : Dilaporkan satu kasus sporotrikosis pada seorang wanita berusia 35 tahun yang berobat pada tanggal 23 Mai 2005 ke poliklinik kulit dan Kelamin, RS Zainoel Abidin Banda Aceb. Diagnosis ditegakkan berdasarkan anamnesis, gambaran klinis, dan pemeriksaan histopatologi. Enam buJan yang Jalu ia digigit oleh tikus sawah, selanjutnya timbul benjolan pada bagian pungung tangan dan lengan atas sebelah kirj. Klinis tampak nodul-nodul eritema sepanjang saluran limfa. Ukuran nodul berkisar 3-5 centi meter, tidak disertai pembengkakan kelenjar limfa regional. Pada pemeriksaan histopatologis'dengan pewamaan PAS dan HE ditemukanjaringan kulit dengan epidermis hiperkeratosis memipih. Dibawahnya tampak radang granulomatik dengan sel plasma, set datia langhans, badan Asteroid, hifa dan spora. Tidak ditemukan tuberkel. Sporothrix schenckii teridentifikasi berdasarkan kultur jaringan kulit pada agar Sabouraud dekstrosa. Secara umum pasien dalam keadaan sehat dan tidak memiliki riwayat penyakit kronis. Terapi yang diberikan adalah itrakonazol 200 mg perhari. Lesi belum menunjukkan respon setelah terapi selama 12 minggu.Diskusi: Sporotrichosis adalah penyakit yangjarang dari deep mikosis, dengan perjalanan subakut dan kronis dari lesi nodular kutan atau subkutan. Penyabanya adalah Sporothrix schenckii yaitu jamur dimorfik. Diberikan pulse terapi Itraconazole 400mg per hari selama satu minggu diikuti dengan istirahat 3 minggu. (JKS2006; 3:171-176) Kata kunci : Sporotrikosis,Sporothrixschenckii, /trakonazol. AbstractBackground: Sporotrichosis is caused by a dimorphic fungus sporothrix schenckii which are spread throughout the world. Sporotrichosis is a rare case. Management of sporotrichosis is relatively difficult.Case: There was a sporotrichosis case on 35-year-old woman managed in Dermato-Venereology polyclinic, Zainoel Abidin Hospita1 Banda Aceh on May 23, 2005. The diagnosis were based on anamnesis, clinical and histopathological examination. The woman told to the doctor that six months ago she was bitten by a field mouse, then lumps appeared on the back of hand and on the left arm, The clinical test showed that there were erythema nodules along the lymphatic channels. The nodules size range from 3 to 5 centimeters, but it did not accompanied by swelling of regional lymph glands. From histopathological examination with PAS and HE staining, there was flattened epidermal hyperceratosis on the skin tissue. Below, there was granulomatous inflammation with plasma cells, Langhans datia cells, asteroid bodies, hyphae and spores. However, there were no tubercles found. Sporothrix schenckii was identified based on the culture of the skin tissue on sabouraud dextrose. Generally, the patient had good health and did not have history of chronic diseases. The therapy given to the patient was itraconazole 200 mg per day. The lesions did not show any response after 12 weeks of treatment. Discussion: Sporotricbosis is a rare disease of deep mycosis, with the course of subacute and chronic from cutaneous or subcutaneous nodular lesions. The cause of the disease is sporothrix schenck.ii that is dimorphic fungus. Itraconazole pulse therapy is given about 400mg per day for one week and the patients should have 3 weeks rest. (JKS 2006,· 3:171-176) Keywords:Sporotrichosis,Sporothrixschenckii, ltraconazole