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"Cytomegalovirus (CMV) merupakan suatu virus DNA rantai ganda, yang termasuk dalam famili Herpesviridae. Infeksi CMV merupakan salah satu penyebab penting mortalitas dan morbiditas pada pasien-pasien imunokompromais. Tulisan ini melaporkan kasus seorang pasien pria imunokompromais berusia 72 tahun dengan batuk yang semakin memburuk hingga perlu dilakukan intubasi, meskipun sebelumnya telah diberikan terapi antibiotik yang adekuat. Pemeriksaan lebih lanjut menunjukkan adanya positif infeksi CMV. Pasien menunjukkan adanya perbaikan setelah pemberian ganciclovir."

"Cytomegalovirus (CMV) is a double-stranded DNA virus and a member of the Herpesviridae family. Cytomegalo- virus infection is one of the important causes of mortality and morbidity in immunocompromised patients. This is a case report of 72 year-old immunocompromised male patient with worsening cough needing an intubation despite previous adequate antibiotic administration. Further examination showed positive CMV infection. The patient showed improvement after administration of ganciclovir."

"The updated second edition of Cutaneous manifestations of infection in the immunocompromised host is an invaluable reference for physicians and ancillary medical professionals involved in the care of patients with impaired immune systems due to cancer, chemotherapy, systemic steroids and other immunosuppressive drugs, HIV/AIDS or organ transplantation. This volume will help you recognize skin lesions and diagnose their infectious cause. Textbook features include, over 350 color images demonstrating pathognomonic, atypical, rare and routine skin lesions. Tables for differential diagnosis of different skin lesions in the immunocompromised host. Complete coverage of infectious pathogens with the patterns of infection and the likely causes in different clinical settings (HIV/AIDS versus solid organ transplantation versus neutropenia post-chemotherapy versus bone marrow recovery post hematopoietic stem cell transplantation. New chapter discussing the role of viruses causing malignancies with cutaneous signs in the immunocompromised patient. "

"Infeksi CMV merupakan penyebab infeksi kongenital tersering di dunia yang menyebabkan kematian maupun kecacatan permanen misalnya keterlambatan perkembangan, gangguan pendengaran dan penglihatan. Prevalensi CMV dipengaruhi oleh letak geografis, status sosial ekonomi dan etnis. Prevalensi CMV kongenital di Amerika berkisar 0,5-1 , sementara di Negara berkembang 0,6-6,1 . Di Indonesia belum terdapat data prevalensi CMV kongenital. Penelitian ini adalah penelitan potong lintang untuk mengetahui prevalensi infeksi CMV pada neonatus yang lahir di RSCM. Penelitian dilakukan dari bulan Oktober 2016 sampai April 2017. Pemilihan subjek penelitian dilakukan dengan teknik consecutive sampling tanpa randomisasi, mengikutsertakan semua neonatus berusia kurang dari 21 hari. Sampel urin dilakukan polymerase chain reaction PCR dan sequencing. Neonatus yang terinfeksi akan menjalani skrining kelainan fungsi pendengaran, penglihatan dan USG kepala serta pemantauan selama 6 bulan. Sebanyak 12 dari 205 5,9 subjek penelitian, terinfeksi CMV atas dasar pemeriksaan PCR dan sequencing CMV urin. Sebanyak 5 dari 12 bayi yang terinfeksi CMV menjalani perawatan dengan diagnosis sepsis dan prematuritas. Satu orang bayi yang terinfeksi CMV meninggal. Prevalensi infeksi CMV pada neonatus di RS Cipto Mangunkusumo adalah 5,9 . Sebanyak 2 subjek merupakan infeksi simtomatik, sementara 10 subjek asimtomatik. Manifestasi klinis yang terlihat adalah gejala sistemik berupa viral-like sepsis, kolestasis, trombositopenia, dan gejala neurologis berupa ventrikulomegali.

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CMV infection is the commonest cause of congenital infection, causing death or permanent disability such as delayed growth, hearing and sight problems. Prevalence of CMV infection is influenced by geographical location, socio economic status, and ethnicity. Prevalence of CMV infection in the US is around 0.5 1 , while in the developing countries varies from 0.6 6.1 . In Indonesia the prevalence of congenital CMV infection is unknown. This study is a cross sectional study to determine the prevalence of congenital CMV infection among neonates in Cipto Mangunkusumo hospital, held from October 2016 to April 2017. Subjects were recruited through consecutive sampling without randomization, from all neonates below 21 days old. Urine sample are collected for polymerase chain reaction PCR and sequencing of CMV. Infected neonates were screened for hearing and sight problems, brain ultrasound, and given a follow up program for 6 months. Twelve out of 205 subjects 5.9 were infected with CMV according to urine PCR and sequencing results. Five of them underwent hospitalization in the NICU due to sepsis and prematurity. One died during follow up. Prevalence of congenital CMV infection in Cipto Mangunkusumo hospital is 5.9 . Two subjects were considered as symptomatic infection, while the other ten asymptomatic. Clinical manifestation were systemic symptoms such as viral like sepsis, cholestasis, thrombocytopenia, and ventriculomegaly."

"Infeksi Strongyloides stercoralis adalah infeksi yang disebabkan oleh cacing nematoda usus pada manusia. Pada individu dengan imunokompromais, S.stercoralis menyebabkan morbiditas yang berat hingga kematian. Tujuan penelitian ini untuk mengetahui pengaruh infeksi S.stercoralis pada individu dengan imunokompromais. Penelitian ini menggunakan rancangan studi kasus kontrol dan dilaksanakan pada Maret - Juni 2013. Subyek merupakan pasien dengan kondisi imunokompromais dan imunokompeten berasal dari rumah sakit dan laboratorium di Jakarta. Bahan klinis (feses) yang berasal dari subyek dikirim ke laboratorium Departemen Parasitologi FKUI. Pengambilan sampel dilakukan dengan teknik consecutive sampling. Seluruh bahan klinis (feses) diperiksa dengan pemeriksaan langsung sediaan basah dan dilanjutkan dengan kultur Harada Mori. Kondisi imun pasien tersebut diketahui dengan menggunakan rekam medik/ surat pengantar yang ada. Total feses yang berhasil dikumpulkan sebanyak 170 feses; Laki-laki sebanyak 108 dan perempuan 62 orang. Kisaran umur pasien yaitu 2-80 tahun dengan rata-rata 33,41 ± 22,65. Pasien dengan imunokompromais sebanyak 31 (18,2%, 31/170) dan imunokompeten 139 (81,8%, 139/170). Sebanyak 18 (10,6%, 18/170) feses positif larva S.stercoralis; 11 (10,2%, 11/108) laki-laki dan 7 (11,3%, 7/62) perempuan. Dari subyek yang positif infeksi S.stercoralis diperoleh 6 (19,4%, 6/31) yang mempunyai status imunokompromais sedangkan pada imunokompeten 12 (8,6%, 12/139). Pada studi ini diperoleh OR 2,54 dengan P-value 0,082 (95% CI: 0,871 - 7.043). Hal ini menunjukkan bahwa status imunokompromais mempunyai hubungan yang positif terhadap infeksi S.stercoralis walaupun secara statistik tidak ada perbedaan signifikan. Dari hasil studi ini dapat menjadi masukan bagi klinisi untuk dasar pengambilan kebijakan untuk meningkatkan penatalaksanaan infeksi dengan keluhan diare terutama pada penderita imunokompromais.

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Strongyloides stercoralis infection is an infection caused by the human intestinal nematode worms. In immunocompromised individuals, S.stercoralis cause severe morbidity and fatality. The purpose of this study was to determine the effect of S.stercoralis infection among individual with immunocompromised state. A case control study was conducted between March-June 2013. Subjects were patients with immunocompromised and immunocompetent condition came from hospitals and laboratories in Jakarta . Who submitted their fecal specimen to parasitology FKUI. Sampling method was done by consecutive sampling technique. Direct examination with wet preparation was performed on the whole specimens followed by filter paper tube Harada Mori culture technique. The patient's immune status was identified from the medical record. There were 170 samples obtained from patients aged 2-80 years old (mean 33,1 ± 22,7); consisted of 108 men and 62 women; immunocompromised patients with as many as 31 (18.2 %, 31/170) and 139 immunocompetent (81.8 %, 139/170). A total of 18 (10.6 %, 18/170) faecal specimens was positive larval S.stercoralis which was proportionately similar between male and female patients. It was found that 6 (19,4%, 6/31) with immunocompromised and 12 immunocompetent (8,6%, 12/139). The odd ratio (OR) was 2,54 with P-value of 0,082 (95% CI: 0,871 to 7,043). Suggesting that immunocompromised state has a positive association to infection S.stercoralis although no statistically significant difference. this study recommends the clinician to increase awarness on S. stercoralis infection and management of infection with symptoms of diarrhea, especially in immunocompromised patients."

"Malaria chemoprevention using mefloquine has become the WHO standard regimen for military personnel who stay in the endemic area for an extended period of time. We reported a case of Plasmodium ovale infection in a young Indonesian Soldier following one year mefloquine prophylaxis 250 mg weekly. Typical fever and chills were experienced two weeks after returning from one year duty in Congo, West-Central Africa. The diagnosis of ovale malaria was made by peripheral blood smear, and 35/250 parasites in small microscopic view was found. Then, he recovered after dihydroartemisin and primaquine combination therapy. This was an unusual case of long-term prophylaxis failure since mefloquine has been recognized as the agent for malaria prevention, even multi-drug-resistance Plasmodium. Dormant stage of Plasmodium ovale, quinoline-resistance potential, and the efficacy of mefloquine itself are discussed as the cause of that phenomenon.

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Kemoprofilaksis malaria menggunakan meflokuin telah menjadi regimen standar WHO bagi anggota militer yang berada di daerah endemik dalam jangka waktu cukup panjang. Dalam laporan kasus ini disajikan kasus infeksi Plasmodium ovale pada anggota muda militer Indonesia yang telah mendapat profilaksis meflokuin 250 mg/minggu selama satu tahun. Pasien tersebut mengalami demam mengigil yang tipikal setelah kembali dua minggu dari tugas di Kongo, Afrika Barat-Tengah. Diagnosis malaria ovale ditegakkan melalui pulasan darah tepi, dan ditemukan 35/250 parasit dalam lapang pandang kecil mikroskop. Kasus kegagalan profilaksis jangka panjang pada dasarnya jarang ditemui, mengingat meflokuin telah menjadi obat pencegahan malaria, bahkan untuk kasus Plasmodium multi-resisten. Diduga, stadium dorman dari Plasmodium ovale, resistensi golongan obat kuinolin, dan efikasi meflokuin menjadi penyebab terjadinya fenomena tersebut."

"Latar Belakang: Infeksi sitomegalovirus (CMV) telah menjadi masalah besar secara global dengan prevalens yang tinggi. Demam neutropenia merupakan kegawatdaruratan anak di bidang onkologi karena dapat meningkatkan morbiditas dan mortalitas, salah satu penyebabnya yaitu infeksi CMV. Mengingat tingginya seroprevalens CMV di Indonesia yang dapat meningkatkan angka kematian pasien keganasan, maka penting untuk memahami profil klinis, laboratoris, dan tata laksana infeksi CMV pada demam neutropenia. Tujuan: Untuk mengetahui prevalens, karakteristik klinis, laboratoris dan tata laksana infeksi CMV pada pasien anak dengan demam neutropenia karena keganasan. Metode: Penelitian ini merupakan uji observasional secara prospektif. Subyek yang diteliti adalah seluruh pasien demam neutropenia usia 1 bulan-18 tahun yang dirawat di bangsal anak Rumah Sakit Cipto Mangunkusumo, Jakarta pada bulan Januari sampai dengan Mei 2024. Hasil: Terdapat 89 episode demam neutropenia yang memenuhi kriteria inklusi dan eksklusi, yang terjadi pada 71 pasien anak dengan median usia 6 tahun (5 bulan-16 tahun), lelaki 56,3%, dan tumor padat 53,5%. Kultur steril terbanyak yaitu darah (78,3%) dan urin (65,2%), dengan kultur positif terbanyak yaitu feses (100%), darah (21,7%), urin (34,8%), dan sputum (100%). Dari kultur yang positif, proporsi kuman terbanyak adalah Klebsiella pneumoniae (29%) dengan sensitivitas antibiotik tertinggi yaitu lini 1 gentamisin (50%), lini 2 sefoperazon sulbaktam (55,5%), dan lini 3 imipenem (72,2%). Terdapat 2 subyek dengan infeksi CMV berdasarkan PCR CMV dan peningkatan IgG 4 kali lipat dalam 4 minggu. Karekteristik klinis yang ditemukan yaitu demam neutropenia episode kedua, durasi demam 1,5 hari, suhu puncak demam 39,45oC, diare, muntah, pucat, dan perdarahan. Kedua subyek dengan status gizi baik. Karakteristik laboratoris yang ditemukan yaitu pansitopenia, peningkatan CRP, dan kultur yang negatif. Karakteristik tata laksana yang ditemukan yaitu pemberian antibiotik empiris, antijamur, dan antivirus valgansiklovir selama 14 hari. Kesimpulan: Prevalens infeksi CMV pada anak dengan demam neutropenia karena keganasan di RSCM sebesar 2,2%, dengan karakteristik klinis demam neutropenia episode kedua, durasi demam 1,5 hari, suhu puncak 39,45oC, gejala diare, muntah, pucat, dan perdarahan. Tidak terdapat karakteristik laboratoris dan tata laksana, tetapi ditemukan pansitopenia, peningkatan CRP, kultur negatif, dan pemberian valgansiklovir selama 14 hari. Hasil tambahan berupa proporsi kuman tertinggi pada pasien demam neutropenia yaitu Klebsiella pneumoniae dengan sensitivitas antibiotik tertinggi yaitu sefoperazon sulbaktam.

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Background: Cytomegalovirus (CMV) infection has become a major problem globally with high prevalence. Neutropenic fever is a pediatric oncology emergency, increasing morbidity and mortality. CMV infection should be considered as a cause of neutropenic fever. Given the high CMV seroprevalence in Indonesia, which can increase cancer patient mortality, it is crucial to understand the clinical profile, laboratory findings, and management of CMV infection in neutropenic fever. Objective: To determine the prevalence, clinical, laboratory, and management characteristics of cytomegalovirus infection in pediatric patients with neutropenic fever due to malignancy. Methods: This research was an observational study prospectively. The subjects were all neutropenic fever patients aged 1 month-18 years who were hospitalized in the Cipto Mangunkusumo Hospital (CMH) pediatric wards from January to Mei 2024. Results: There were 89 episodes of neutropenic fever that met the inclusion and exclusion criteria, found in 71 pediatric patients, with median age was 6 years old (5 months-16 years old), male 56.3%, and solid tumor 53.5%. Sterile results were found in blood (78.3%) and urine (65.2%) cultures. Positive cultures were found in feces (100%), blood (21.7%), urine (34.8%), and sputum (100%). Klebsiella pneumoniae (29%) was the highest proportion of positive cultures with the highest sensitivity antibiotic in the first line was gentamicin (50%), second line cefoperazone sulbactam (55.5%), and third line imipenem (72.2%). Two subjects were CMV infection based on PCR CMV and IgG increasing 4 times in 4 weeks. Clinical characteristics were second episode of neutropenic fever, duration of fever 1.5 days, peak temperature 39.45oC, diarrhea, vomiting, pale, bleeding, and both had good nutritional status. Laboratory characteristics showed pancytopenia, increasing CRP, and negative culture. Management characteristics included empirical antibiotic, antifungal, and antiviral valganciclovir for 14 days. Conclusion: The prevalence of CMV infection in neutropenic fever at CMH was 2.2%. Clinical characteristics were second episode of neutropenic fever, duration of fever 1.5 days, peak temperature 39.45oC, diarrhea, vomiting, pale, and bleeding. There is no laboratory and management characteristics, but found pancytopenia, increased CRP, negative culture, and administering valganciclovir for 14 days. The additional result was Klebsiella pneumoniae as the highest microbe with the highest antibiotic sensitivity was cefoperazone sulbactam."

"Dampak dari perawatan di ruang rawat inap isolasi selama berhari-hari pada klien yang terkonfirmasi positif COVID-19 dapat menimbulkan masalah psikososial yaitu ansietas. Karya ilmiah ini menjelaskan asuhan keperawatan ansietas pada klien COVID-19 yang sedang melakukan perawatan di ruang rawat inap dengan teknik relaksasi, teknik distraksi dan kolaborasi medikasi. Metode karya ilmiah yang digunakan adalah laporan kasus tunggal. Karya ilmiah dilakukan selama 4 hari di ruang rawat inap isolasi RS Universitas Indonesia. Laporan kasus ini berfokus kepada klien Ny. F usia 25 tahun yang setelah dipindahkan dari IGD ke ruang rawat inap mengeluhkan napas tidak teratur dan sulit untuk tidur karena takut sendirian di ruang perawatan. Hasil evaluasi yang didapatkan adalah hilangnya tanda dan gejala ansietas, serta penurunan hasil Hospital Anxiety and Depression Scale (HADS) dari abnormal menjadi normal.

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The impact of hospitalization in single treatment room for days to the patients who COVID-19 positive tested could lead to the psychosocial problems, one of them is anxiety. This study explained an overview of anxiety nursing care in a patient with COVID-19 who was hospitalized in single treatment room by means of relaxation and distraction techniques also collaboration in medication. The method of this study is single case study. The study was conducted for 4 days in single treatment room of University Indonesia’s Hospital. This study focused on Mrs. F, the 25 years old patient that after being transferred from the emergency room to the single treatment room, the patient complains of having irregular breathing and could not sleep at night because the patient was too afraid to be alone in the room. The evaluation result obtained were the disappearance of sign and symptoms of anxiety and the decreasing result of Hospital Anxiety and Depression Scale (HADS) form abnormal to normal."

"Dampak dari perawatan di ruang rawat inap isolasi selama berhari-hari pada klien yang terkonfirmasi positif COVID-19 dapat menimbulkan masalah psikososial yaitu ansietas. Karya ilmiah ini menjelaskan asuhan keperawatan ansietas pada klien COVID-19 yang sedang melakukan perawatan di ruang rawat inap dengan teknik relaksasi, teknik distraksi dan kolaborasi medikasi. Metode karya ilmiah yang digunakan adalah laporan kasus tunggal. Karya ilmiah dilakukan selama 4 hari di ruang rawat inap isolasi RS Universitas Indonesia. Laporan kasus ini berfokus kepada klien Ny. F usia 25 tahun yang setelah dipindahkan dari IGD ke ruang rawat inap mengeluhkan napas tidak teratur dan sulit untuk tidur karena takut sendirian di ruang perawatan. Hasil evaluasi yang didapatkan adalah hilangnya tanda dan gejala ansietas, serta penurunan hasil Hospital Anxiety and Depression Scale (HADS) dari abnormal menjadi normal.

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The impact of hospitalization in single treatment room for days to the patients who COVID-19 positive tested could lead to the psychosocial problems, one of them is anxiety. This study explained an overview of anxiety nursing care in a patient with COVID-19 who was hospitalized in single treatment room by means of relaxation and distraction techniques also collaboration in medication. The method of this study is single case study. The study was conducted for 4 days in single treatment room of University Indonesia’s Hospital. This study focused on Mrs. F, the 25 years old patient that after being transferred from the emergency room to the single treatment room, the patient complains of having irregular breathing and could not sleep at night because the patient was too afraid to be alone in the room. The evaluation result obtained were the disappearance of sign and symptoms of anxiety and the decreasing result of Hospital Anxiety and Depression Scale (HADS) form abnormal to normal."