Kandidiasis pada anak dengan lupus eritematosus sistemik disertai ko-infeksi tuberkulosis

Candidiasis in children with systemic lupus erythematosus with tuberculosis co-infection

Tuty Amalia, Riani Setiadhi

Abstract


Pendahuluan: Kandidiasis oral adalah salah satu infeksi oportunistik yang sering dijumpai pada penderita lupus eritematosus sistemik, yaitu suatu penyakit autoimun yang menyebabkan terjadinya inflamasi kronis multiorgan. Prevalensi tuberkulosis lebih tinggi pada penderita lupus eritematosus sistemik disebabkan adanya kelainan imun yang diderita serta terapi immunosupresif yang diterima. Tujuan penulisan laporan kasus ini adalah menggambarkan lupus eritematosus sistemik disertai ko-infeksi tuberkulosis sebagai faktor predisposisi terjadinya kandidiasis oral. Laporan kasus: Seorang perempuan berusia 16 tahun dikonsultasikan oleh bagian Ilmu Kesehatan Anak dengan keluhan bercak putih di seluruh rongga mulut, terasa perih, dan tidak dapat makan sejak 3 hari sebelumnya, terdiagnosis lupus eritematosus sistemik sejak 1 tahun sebelumnya, dan tuberkulosis sejak 1 bulan sebelum masuk rumah sakit. Pemeriksaan ekstra oral menemukan konjungtiva anemis, sklera non ikterik. Kelenjar getah bening servikal kanan teraba sakit saat palpasi, bibir kering dan deskuamasi, sudut mulut terdapat celah memanjang. Pemeriksaan intra oral mendapatkan plak putih dapat dikerok dan meninggalkan daerah eritema pada mukosa labial atas dan bawah, mukosa bukal kiri dan kanan, dorsum lidah, lateral lidah kiri dan kanan. Terdapat lesi erosif yang terasa sakit, ukuran 20 x 2 mm pada ventral lidah. Eritema multipel di palatum tidak terasa sakit saat palpasi. Diagnosis kondisi oral adalah kandidiasis pseudomembran akut. Terapi yang diberikan ialah chlorhexidine digluconate 0,12% dan nistatin suspensi oral, pasien mengalami perbaikan pada hari ketiga terapi. Simpulan: Terapi lupus eritematosus sistemik disertai ko-infeksi tuberkulosis dengan faktor predisposisi terjadinya kandidiasis oral.adalah chlorhexidine digluconate 0,12% dan nistatin suspensi oral, pasien mengalami perbaikan pada hari ketiga terapi.

Kata kunci: Kandidiasis pseudomembran akut, lupus eritematosus sistemik, tuberkulosis.

 

ABSTRACT

Introduction: Oral candidiasis is an opportunistic infection often found in patients with systemic lupus erythematosus, an autoimmune disease that causes chronic multiorgan inflammation. The prevalence of tuberculosis is higher in patients with systemic lupus erythematosus due to the presence of immune disorders as well as the side effect of immunosuppressive therapy. This case report was aimed to describe systemic lupus erythematosus with tuberculosis co-infection as a predisposing factor for oral candidiasis. Case report: A 16-year-old woman was consulted from the Paediatrics Department with white spots all over the oral cavity with sore feeling and could not eat since 3 days before, was diagnosed with systemic lupus erythematosus since 1 year back, and tuberculosis since 1 month before hospitalised. An extraoral examination found anaemic conjunctiva and non-jaundice sclera. The right cervical lymph node feels pain when palpation, dry lips and desquamation, the corners of the mouth were found elongated fissures. Intraoral examination to get white plaque can be scraped off and leave erythema areas on the upper and lower labial mucosa, left and right buccal mucosa, dorsum of the tongue, lateral left and right tongue. There was a painful erosive lesion with a size of 20 x 2 mm on the ventral tongue. Multiple erythemas in the palate did not hurt when palpation. The diagnosis of an oral condition is acute pseudomembranous candidiasis. Therapy given was 0.12% chlorhexidine digluconate and nystatin oral suspension; the patient experienced improvement on the third day of treatment. Conclusion: Systemic lupus erythematosus with tuberculosis co-infection therapy with predisposing factors of oral candidiasis are 0.12% chlorhexidine digluconate and nystatin oral suspension; the patient experienced improvement on the third day of the treatment.

Keywords: Acute pseudomembranous candidiasis, systemic lupus erythematosus, tuberculosis.


Keywords


Kandidiasis pseudomembran akut, lupus eritematosus sistemik, tuberkulosis, acute pseudomembranous candidiasis, systemic lupus erythematosus, tuberculosis.

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DOI: https://doi.org/10.24198/jkg.v31i3.23361

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