Lapsus candidiasis in AIDS
-
Upload
ayu-natalia -
Category
Documents
-
view
233 -
download
2
description
Transcript of Lapsus candidiasis in AIDS
EM, PSEUDOMEMBRAN CANDIDIASIS AND ULCER IN AIDS CONDITIONBAldy Novrizal
0906554390
Patient’s data
Medical Record : 389-14-38Place : 7th Floor RSCMDate of 1st visit : November 27 th 2013
Routine DataName : Mr. A.MSex : MaleAge : 43 years old
Anamnesis
Suffering HIV since
2010
Treatment ARV at Cibinong
hospital
Few days use ARV drugs
fever & dypsnea stop drugs
diagnosed suffer an Sanprima
allergy
Reffered to RSCM
continue starting allergy
reaction
Anamnesis
visited to POKDISUS( 1 week before hospitalized)
dypsnea, cough with sputum, fever, nausea
swelling on the eyes and vesicle
on the skindiagnosed the
patient has allergy
because the use of
neurapin, not becausecotrim
oxacole
Stop Neurapin
Anamnesis
DM since 3 years
No Hypertention and Asthma
TB (negatif)
Alcohol, Premiscuitas
refused
Was a victims sexual
abusement in 2009
Problem List
Allergic Drug Reaction type EM AIDS but not yet treated with ARV Sepsis e.c HCAP dd lungs TB DM type 2 RBBB Hordeolum Sinistra
AnamnesisPatient was reffered to be treated together with WD/ Allergic drugs reaction.
Multiple ulcers on the tongue and lips
Wound on the mouth since 1 months ago, which preceeded with wound on the skin
Painful mouth
Used drugs: Betadine gargle 4x/day, Nystatin 4x/day 1cc diluted, vaselin for lips
Extra Oral Examination
Lymph Gland Right Submandibula
Left Submandibula -
Submental -
Right Cervical -
Left Cervical -
Lips Ulcer and crustae yellow on the upper and bellow
Face -
Circum Oral -
Others -
Extra Oral Photos
Intra Oral Examination (nov 27th ‘13)
Intra Oral Examination (nov 27th ‘13)
Laboratory Test
LED 70 mm/jam Basofil 0,24 %
Hb 11,6 gr% Eosinofil 0,1 %
Ht 33,5 % Batang 80,6 %
Eritrosit 3,85 juta/mm3 Segmen 80,6 %
MCV 87 Um Limfosit 10,9 %
MCH 30,1 Pg Monosit 8,2 %
MCHC 34,6 G/dl Blast 70 %
Trombosit 409/mm3 CD 4 28 cell/μl
Retikulosit SGOT 20
Leukosit 10,16/mm3 SGPT 29
Diagnosis
Suspect Manifestation Oral EM Pseudomembran candidiasis oral Non specific ulcer related with
immunocompromised
Treatment Plan (in nov 27th ‘13)Nystatin replaced by:R/ Fluxonazole 150 mg no VS 1 dd 1treatment for lips :
Compress on lips with minocep and sterile gauze (10 minute 3x/day)Topical medicine :R/ Amox 500 mg
Prednison 5 mgAvil 25 mgVaselin lanolin 30 g
m.f ungS oles Bibir 3x/ hari
Treatment for ulcer: garg minocep gargle 3x/day
Control (in nov 29th ‘13)-Pseudomembran candidiasis healing - Krusta di bibir kering- Terlihat Ulser di vental lidah
- Flukonazole stop lanjut nystatin 4x/hr
- diberikan resep:
R/ Minosep gargle fl No IS 1 dd 10 cc
R/ Doxycyclin 100 mg no XIIS 3 dd 1 kumur buang
R/ Cinolon oint tube no IS 3 dd 1
Control
On des 2nd:- mothwash 1x/day- mouth still painfull and hard to swallow- Obat Racikan not yet available- ulcer healing on ventral and dorsum of the tongue- krusta healing on anterior lips
Erythema Multiforme- Occasionally
triggered byherpetic infection/drugs
- Affect to adolescents or young adult
- Mild fever and systemic upset may be associated
- Lips frequently swollen, crusted and bleeding
- Cutaneous lesion may consist of widespread erythema alone
- Attacks may recur at interval of several months
MANAGEMENT- Patient should be warned of possibility of recurrences-
Systemiccorticosteriod (symptomatic relief)
- Antibiotic usually given in severe case
Pseudomembran Candidiasis Oral/Thrush
- Acute Candidiosis- Common in HIV infection and
indicates low immunity- Creamy soft patches, readily
wiped off the mucosa- Smear shows many gram-
positive hyphae- Respond to antifungal or
itraconazole- Predisposing Factor:
Immunodeficiency (ex: Diabetes melitus and AIDS)
Thank You