48-YEAR-OLD MALE WITH STAGE III HIV WITH PULMONARY TB,

ORAL CANDIDA, STEVENS-JOHNSON SYNDROME EC OAT,

PASITOPENIA EC HIV, AND CHRONIC HEPATITIS B
OPPORTUNISTIC INFECTION
Masrian Hendrianto1, Satriyo Budi Susilo2, Evi Nurhayatun2, Dhani Redhono
Harioputro2, Tatar Sumandjar2, Agus Jati Sunggoro3, Paulus Kusnanto4, Arie
Kusumawardhani5, Jatu Aphridasari
1
Medical Faculty of Sebelas Maret University, Dr. Moewardi Hospital, Surakarta,
Indonesia
2
Division of Tropical Infection, Department of Internal Medicine, Dr. Moewardi
Hospital, Surakarta, Indonesia
3
Division of Hematology, Department of Internal Medicine, Dr. Moewardi
Hospital, Surakarta, Indonesia
4
Division of Gastroenterology, Department of Internal Medicine, Dr. Moewardi
Hospital, Surakarta, Indonesia
5
Department of Dermatovenerology, Dr. Moewardi Hospital, Surakarta,
Indonesia
6
Department of Pulmonology, Dr. Moewardi Hospital, Surakarta, Indonesia

BACKGROUND
Human Immunodeficiency Virus (HIV) is a pathogen that attacks the human
immune system. HIV patients are prone to Stevens-Johnson syndrome (SJS). SJS
is an immune complex-mediated hypersensitivity disorder, caused by drugs, viral
infections, and malignancies.
CASE REPORT
48-year-old male patient with complaints of dry, flaking skin over nearly the
entire body for 14 days prior to admission. The complaints were felt after taking
1x3 tablets of Anti-tuberculosis FDC for 2 weeks and one dose of TLE ARV.
Laboratory tests revealed pancytopenia (Hb 7.6, Leukocytes 1.2, Platelets 11),
reactive HbsAg, reactive HIV by using the three reagent test, and from Rapid
Molecular Test the MTB are Detected Low. From the radiologic examination such
as Thorax X-Ray shows former pulmonary inflammation and a prominent left
hilum, suspecting lymphadenopathy; while the abdominal ultrasound shows
Parenchymal Liver Disease. Patients were given non-total bed rest, diet of
1500kcal per day, IVFD RL maintenance dose, methylprednisolone injection
62.5mg/12 hours, omeprazole injection 40mg/12 hours, curcuma 3x1, albumin
capsules 3x1, nystatin drop 2x1 ml (10 drops in 100cc then rinse), Povidone-
iodine mouthwash 2x a day, active substance urea 10% topical cream 2x a day,
Triamcinolone acetonide topical 2x a day. Administer OAT and antiretroviral in
Separate Drug Formula (SDF) when symptoms improve and 480cc of PRC and 4
packs of TC transfusion.
DISCUSSION
Antiretroviral medicine were administered to suppress the viral load and reduce
the risk of opportunistic infection. The TLE ARV specifically used to inhibit the
proliferation of the HIV virus and specific medicines are used to treat the
opportunistic infection that happened as the consequences of low immune system
from the HIV.
CONCLUSION
Patients are given SDF anti-tuberculosis and SDF ARV (TLE) in order to
determine which medications are safe for use in SJS patients.
Keywords : HIV, Pulmonary TB, Candidiasis Oral, SJS, Hepatitis B