Studi Kasus: Diagnosis dan Pengobatan Stomatitis pada Kucing Domestik

Stomatitis is an inflammation that occurs in the oral mucosal tissue, characterized by ulcers. This case study aims to diagnose and treat stomatitis in a cat. A 7-month-old female domestic cat weighing 2.7 kg with lethargy, lost of appetite, decreased thirst, and was having sores for 2 days was examined. The cat was examined physically include anamnesis, an inspection of body condition and eating behavior, palpation of the skin, hair, and parts of the body that can be palpated, and auscultation of the thorax and abdomen. The blood sample that was examined includes the erythrocyte count, hemoglobin value, leukocytes count, and their differentials. Physical examination results showed hyperemic gingival, swollen submandibular and retropharyngeal lymphoglandula, and there were multiple ulcers on the lips and tongue. Hematological examination showed thrombocytopenia and monocytosis. The stomatitis was diagnosed to the cat with a good prognosis. Therapy was given for 5 consecutive days in the form of intramuscular injection of Amoxycillin 10 mg/kg BW twice daily, intramuscular injection of diphenhydramine HCl 1 mg/kg BW once daily, subcutaneous injection of 0.5 ml vitamin C once daily, oral administration of 0.5 ml multivitamin twice daily, and povidone-iodine for gargle twice a day applied lightly to the lesion area. Stomatitis in this case study was cured within 5 days by treating with amoxicillin, diphenhydramine HCl, vitamin C, multivitamins, and topical povidone-iodine. Keywords: Amoxicillin; Cat; Stomatitis; Vitamin C. Abstrak Stomatitis merupakan radang yang terjadi pada jaringan mukosa mulut yang ditandai adanya ulser. Studi kasus ini bertujuan melakukan diagnosis dan pengobatan stomatitis pada kucing. Studi kasus ini melaporkan seekor kucing domestik betina umur 7 bulan dengan berat badan 2,7 kg dengan keluhan lesu, tidak ada nafsu makan dan minum, serta menderita sariawan sejak 2 hari sebelum diperiksa. Kucing diperiksa secara fisik meliputi anamnesa, inspeksi terhadap kondisi tubuh dan perilaku makan, palpasi terhadap kulit, rambut, dan permukaan tubuh lainnya, serta auskultasi pada daerah thorax dan abdomen. Sampel darah kucing diperiksa terhadap jumlah eritrosit kadar hemoglobin, jumlah leukosit dan diferensialnya. Hasil pemeriksaan fisik menunjukkan limfoglandula submandibula dan retropharingeal bengkak, gingiva hiperemi serta adanya ulser multiple pada bibir dan lidah. Hasil pemeriksaan darah menunjukkan trombositopenia dan monositosis. Berdasarkan hasil pemeriksaan kucing didiagnosis stomatitis dengan prognosis fausta. Kucing diberi terapi selama 5 hari berupa amoxicilin dosis 10 mg/kg BB dua kali sehari secara intramuskuler, dyphenhidramin HCl 1 mg/kg BB satu kali sehari secara intramuskuler, vitamin C sebanyak 0,5 ml satu kali sehari secara subkutan, multivitamin sebanyak 0,5 ml dua kali sehari secara per oral, dan povidone iodine dua kali sehari dioleskan pada lesi stomatitis. Stomatitis pada kasus ini dapat disembuhkan dalam waktu 5 hari dengan pemberian amoxicilin, dipenhidramin HCl, vitamin C, multivitamin secara sistemik dan povidone iodine secara topikal. Kata kunci: Amoksisilin; Kucing; Stomatitis; Vitamin c

Unusual Complicated Gastric Ulcers

We here draw attention to a practical issue: the approach to certain unusual gastric ulcers with haemorrhage- or perforation-induced complications. This category of ulcers, i.e., giant (over 2–3 cm) and multiple ulcers, is rarely encountered. We discuss the circumstances determining the occurrence of such lesions, their diverse aetiology and pathogenesis, their common manifestations, and the severity of their evolution. Some of the lesions are benign (chronic or acute ulcers), whereas others are neoplastic: carcinoma, stromal tumours, and lymphomas. In gastric ulcers, the characteristics of this particular and rare category of lesions strictly places them in the surgical field, requiring primary surgical intention. Conservative treatments are not effective in such cases, and preoperative biopsies are not appropriate for emergency interventions. Whether these unusual ulcers are benign or malign, they need to be surgically removed.

Advanced ulcerative tumefactive lesions of the mucocutaneous surface in previously unrecognized Langerhans Cell Histiocytosis

Langerhans cell histiocytosis (LCH) is an uncommon systemic disease characterized by the infiltration of one organ or more by Langerhans cells. Its clinical presentation is heterogeneous and depends on the affected organs. We report the rare case of a 43-year-old female presenting herself with central diabetes insipidus and receiving nasal desmopressin spray. Later, the patient developed multiple papules and pustules progressing to multiple ulcers affecting the retroauricular and axillary folds, as well as the oral and genital mucosas. The skin lesions had been evolving for several months. A histopathological examination of a skin biopsy confirmed the clinical suspicion of LCH.

Lucio Phenomenon: A Rare Manifestation of Leprosy in Selangor, Malaysia

Leprosy is a chronic infectious disease caused by Mycobacterium leprae, predominantly affecting the skin and peripheral nerves. Lucio phenomenon is a rare reactional state presenting in patient with lepromatous leprosy and described as acute cutaneous necrotising vasculitis. We discussed the case of a 38-year-old male patient presenting with oedematous and dusky discolouration of bilateral hands and feet associated with diffuse facial involvement. His skin condition gradually worsened to form multiple ulcers with bizarre shaped purpuric lesion over bilateral upper and lower limbs, trunk, and face. Histopathological examination of the skin biopsy showed multiple acid-fast bacilli and diagnosis of Lucio’s phenomenon was made in the background of lepromatous leprosy. He was treated with multi drug therapy (MDT) as recommended by the WHO guidelines. A better understanding of rarer manifestation of this illness is important for early diagnosis and to prevent significant morbidity associated with it.International Journal of Human and Health Sciences Supplementary Issue-2: 2021 Page: S20

Long-Term Outcome of Children with Short Bowel Syndrome Treated with a Modification of the STEP Technique Avoiding Mesenteric Defect

Background The Serial Transverse Enteroplasty Procedure (STEP) Registry has reported a 47% success to achieve enteral autonomy in pediatric short bowel syndrome (SBS). We have performed the STEP with a technical modification (MSTEP) consisting in stapler application without mesenteric defects that can also be applied to the duodenum. Our experience with this technique is described. Materials and Methods In this study, 16 children with SBS underwent MSTEP (2005–2019). Indications were nutritional autonomy achievement (n = 11, with duodenal lengthening in 5/11) and bacterial overgrowth treatment (n = 5). Results With a median follow-up of 5.8 years (0.7–13.7 years), 5 of 11 (45%) patients achieved enteral autonomy, 4 of them with duodenal lengthening. Four of four who preserved > 50% colon, while only one of seven with < 50% of colon achieved enteral autonomy (p < 0.05). After redo procedures, three of four attained enteral autonomy. Thus, 8 of 11 (73%) progressed to enteral autonomy, including all with duodenal lengthening. One child, already parenteral nutrition free, died due to central line sepsis. All the patients from the bacterial translocation group improved their metabolic/nutritional status, but one required subsequent enterectomy of the lengthened intestine due to multiple ulcers in the staple lines. Conclusion The effectiveness of MSTEP to achieve enteral autonomy seems similar to the classical STEP. It can be applied to the duodenum. The retained colon length may influence the post-STEP enteral autonomy achievement.

Jejunostomia. Alkan (Deut. med. Woch., 1921, No. 51)

This operation is the best type of surgical intervention for fresh burns of the esophagus and stomach. In older calloused, perforating gastric ulcers, especially those lying closer to the cardia, as well as in case of multiple ulcers and severe bleeding it is equal to resection in its therapeutic value, especially in severely weakened patients.

Cecal amebiasis mimicking inflammatory bowel disease

Amebiasis is a frequently occurring parasitic infection in South East Asia. We present a case of a 54-year-old man with right lower quadrant abdominal pain that persisted for longer than 1 year. He had been diagnosed with inflammatory bowel disease in Indonesia. His abdominal pain persisted, despite therapy, and he visited Malaysia for transnational medical advice. Abdominal ultrasound showed fatty liver, gallbladder polyps, and a small left renal stone. Colonoscopy showed multiple ulcers in the cecum and a histopathological examination confirmed amebic infection of the cecum. The colonic ulcers subsided after anti-amebic treatment. This case highlights the need to consider the differential diagnosis of amebic colitis in patients presenting with manifestations of inflammatory bowel disease, especially in patients who live in or have traveled to endemic areas.