Multiorgan Involvement in Severe Plasmodium Falciparum Malaria: A Case Report of Hepatopathy and Acute Kidney Injury

Rionaldo Anthonius; Ni Made Dewi Dian Sukmawati

doi:10.56951/ywp9an33

Multiorgan Involvement in Severe Plasmodium Falciparum Malaria: A Case Report of Hepatopathy and Acute Kidney Injury

Penulis

Rionaldo Anthonius Internal Medicine Specialist Program, Faculty of Medicine, Udayana University/Prof. dr. I.G.N.G. Ngoerah General Hospital, Denpasar, Bali, Indonesia
Ni Made Dewi Dian Sukmawati Department of Internal Medicine, Faculty of Medicine, Udayana University/RSUP Prof. dr. I.G.N.G. Ngoerah, Denpasar, Bali, Indonesia

DOI:

https://doi.org/10.56951/ywp9an33

Kata Kunci:

malaria berat, Plasmodium falciparum, hepatopati malaria, cedera ginjal akut, disfungsi multiorgan

Abstrak

Malaria masih merupakan salah satu penyebab kematian yang signifikan di seluruh dunia. Manifestasi malaria berat dapat berupa disfungsi multiorgan, termasuk cedera hati akut dan cedera ginjal akut. Seorang pria berusia 46 tahun datang dengan riwayat demam tinggi, menggigil, dan ikterus selama 21 hari setelah melakukan perjalanan ke Jayapura, Papua. Pemeriksaan fisik menunjukkan sklera ikterik, hepatomegali (15 cm), dan splenomegali (skala Schuffner 2). Analisis laboratorium mengonfirmasi infeksi Plasmodium falciparum dengan densitas parasit sebesar 31.920 parasit/μl, hiperbilirubinemia berat (bilirubin total 13 mg/dl), peningkatan kadar transaminase, dan cedera ginjal akut. Pasien diobati dengan artesunate intravena (2,4 mg/kg) pada jam ke-0, 12, dan 24, diikuti dosis harian terapi kombinasi berbasis artemisinin oral. Eliminasi parasit tercapai dalam 48 jam, dan pemulihan klinis serta perbaikan fungsi hati dan ginjal tercapai pada hari ke-7. Identifikasi dini riwayat perjalanan yang relevan sangat penting untuk penegakan diagnosis dan tata laksana malaria berat serta komplikasinya.

Unduhan

Baca Selengkapnya

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