Treatment of disseminated TB with drug induced hepatitis/case study

Miliary Tuberculosis (TB) usually has an insidious clinical manifestation including fever, weight loss, night sweats, and little in the way of localizing symptoms or signs. There may be concurrent TB meningitis with associated symptoms. A 35-year old male has known case of pulmonary TB and HCV before three years ago. Presented to emergency department with Fever since 3-weeks ago, abdomen pain, headache since 10 days.

A Rare Case of Propofol-Induced Acute Hepatitis in after a Brief Endoscopic Retrograde Cholangio-Pancreatography (ERCP)

Background: Given its favourable pharmacokinetic parameters, propofol is commonly used for sedative procedures. The agent is extensively metabolized in the liver and there are sporadic reports of propofol induced acute hepatitis. Case: A 73-year-old Chinese lady underwent a routine endoscopic retrograde cholangio-pancreatography with propofol sedation who developed deranged liver function tests 4 hours post procedure peaking on day 1. She improved with conservative management only and no other causes for the clinical picture was found. A review of the literature revealed several case reports where propofol have been implicated as a triggering factor. Conclusion: Although propofol produces rapid recovery without major adverse effects in the vast majority of cases, it is worth bearing in mind the possibility of idiosyncratic reactions that are detrimental to the liver.

Good Syndrome with Cytomegalovirus Hepatitis: Successful Resection of Thymoma: A case report

Background Good syndrome is a rare condition, manifesting as immunodeficiency due to hypogammaglobulinemia associated with thymoma. Herein, we present a patient with Good syndrome whose thymoma was resected after treatment of cytomegalovirus hepatitis. Case presentation The patient was a 45-year-old woman presenting with fever, cough, and nasal discharge, and was diagnosed with thymoma and hypogammaglobulinemia. She subsequently developed cytomegalovirus hepatitis that was treated by immunoglobulin. After resolution of the hepatitis, she underwent thymectomy through a left anterior thoracotomy. Her postoperative course was uneventful, and while receiving ongoing immunoglobulin therapy, she has been doing well without signs of infection. Conclusions Management of infections is important for patients with Good syndrome. To minimize the risk of perioperative infection, we should take care while planning the surgical approach and procedure.

Pemeriksaan Ultrasonografi Hepar menjadi Pemeriksaan Penunjang yang Tepat untuk Diagnosa Hepatitis

Hepatitis is inflammation of the liver due to viral or alcohol infection. Hepatitis can cause death and the case always increases every year both in Indonesia and the world. The aim of this study is to describe and evaluate the management of examination such as patient preparation procedure, tool preparation, patient position, transducer placement, transducer used, and ultrasound image of hepatitis. This research was conducted by qualitative descriptive method. The population is all patients who perform liver ultrasound examination at RSUD Cengkareng Jakarta. The samples used were patients who performed liver ultrasound examination with clinical hepatitis. The number of samples used is 2 patients. After being analyzed and observed, ultrasonography is an accurate and accurate examination of the hepatitis case. Additional scripting techniques are sometimes required in certain cases to make the results more optimal. Based on this research, it can be expected that ultrasound modalities can be used as an appropriate supporting tool in establishing clinical hepatitis with accurate, fast, cheap and safe results.