Keterlambatan diagnosis: kasus kusta tipe borderline tuberculoid dengan reaksi reversal ringan dan cacat kusta tingkat dua disertai riwayat tuberkulosis paru
Year: 2024
Type: article
Study design: Case Report
Abstract: Introduction: Delay in the diagnosis of leprosy is related to the occurrence of disability. The relationship between tuberculosis infection and leprosy is rarely reported. This case report aims to describe a case of borderline tuberculoid (BT) leprosy with leprosy reactions and leprosy disabilities to improve understanding of leprosy and the spectrum of this infectious disease. Case: Male, 20-year-old, came with complaints of red spots since 7 years ago. The patient also complained of crooked left hand, limp on right leg, and had a history of pulmonary tuberculosis (TB). On physical examination showed multiple annular plaques, hypoesthesia sensibility examination, increased monofilament, and asymmetrical enlargement of multiple nerves were found. Histopathological examination revealed epithelioid granulomas. The patient was diagnosed with borderline tuberculoid leprosy with a mild reversal reaction and grade 2 leprosy deformity. The patient was given multibacillary (MB) multi drug therapy (MDT). Clinical improvement and bacterial index improvement are obtained. However, leprosy disability cannot be fully overcome even though MDT therapy has been given. Conclusion: Early diagnosis and treatment are very important to prevent disability. A history of previous inadequate therapy requires close monitoring of treatment resistance. Pendahuluan: Keterlambatan diagnosis kusta berhubungan dengan terjadinya kecacatan. Hubungan infeksi tuberkulosis dan kusta masih jarang dilaporkan. Laporan kasus ini bertujuan untuk mendeskripsikan kasus kusta tipe borderline tuberculoid (BT) dengan reaksi kusta dan cacat kusta untuk dapat meningkatkan pemahaman mengenai kusta dan spektrum penyakit infeksi ini. Kasus: Laki-laki, 20 tahun, datang dengan keluhan bercak merah sejak 7 tahun lalu. Pasien juga mengeluh jari-jari tangan kiri bengkok, kaki kanan lunglai, serta memiliki riwayat tuberkulosis (TBC) paru. Pemeriksaan fisik didapatkan plak anular multipel, pemeriksaan sensibilitas hipoestesi, peningkatan pada monofilamen, dan pembesaran saraf multipel yang asimetris. Pemeriksaan histopatologi didapatkan granuloma epitelioid. Pasien didagnosis dengan kusta tipe borderline tuberculoid dengan reaksi reversal ringan dan cacat kusta tingkat 2. Pasien diberikan multi drug therapy (MDT) multibasiler (MB). Perbaikan klinis dan indeks bakteri didapatkan perbaikan. Namun, kecacatan kusta tidak dapat teratasi dengan maksimal walaupun telah diberkan terapi MDT. Simpulan: Diagnosis dan terapi dini sangat penting untuk mencegah terjadinya kecacatan. Riwayat terapi inadekuat sebelumnya memerlukan monitoring ketat terjadinya resistensi pengobatan.
Source: Intisari Sains Medis
Institutions: Udayana University, Rumah Sakit Umum Pusat Sanglah Denpasar
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4414836626
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