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Satu kasus Staphylococcus aureus sebagai agen penyebab infeksi sekunder kutaneus pada pemfigus vulgaris



Abstract

Introduction: Pemphigus vulgaris is an autoimmune bullous disease affecting skin and mucosa with intraepidermal bullae. The disease is characterized by bullae that break easily into erosion, positive Nikolsky sign and mousy odor. Staphylococcus aureus is a Gram-positive bacteria it can be a commensal or pathogenic on human skin.

Case Report: We report a case of a 12-year-old patient with pemphigus vulgaris with secondary infection based on blood test, Gram staining and wound base culture. From wound base culture, examination we found Staphylococcus aureus. Based on clinical examination, complete blood examination, Gram examination and wound base culture, we concluded that Staphylococcus aureus can cause infection in pemphigus vulgaris due to extensive wounds that make bacteria easily colonized the damaged skin, and immunosuppressive condition also increase the risk of infection. Patients was given methylprednisolone, cotrimoxazole, chlorpheneramine maleate, wound care with open dressing sodium chloride 0.9%, and gentamicin ointment 0.1%. During the observation there were clinical improvement of the patient.

Conclusion: The diagnosis and management of pemphiigus vulgaris has to be delivered carefully as the patients have a high risk of secondary infection. Therefore, preventive and curative measures for infection have to be considered.

 

Pendahuluan: Pemfigus vulgaris adalah penyakit autoimun bulosa yang menyerang kulit dan mukosa, dengan letak bula intraepidermal. Penyakit ini ditandai dengan bula yang mudah pecah menjadi erosi, tanda Nikolsky positif dan mousy odor. Staphylococcus aureus merupakan bakteri Gram-positif yang dapat bersifat komensal atau patogen pada kulit manusia.

Laporan Kasus: Kami melaporkan kasus pemfigus vulgaris yang disertai tanda infeksi sekunder berdasarkan hasil pemeriksaan darah, pewarnaan Gram dan kultur dasar luka. Dari hasil kultur dasar luka ditemukan bakteri Staphylococcus aureus. Berdasarkan pemeriksaan klinis, pemeriksaan darah lengkap, pemeriksaan Gram dan kultur dasar luka, disimpulkan bahwa Staphylococcus aureus dapat menyebabkan infeksi sekunder pada pemfigus vulgaris karena adanya luka yang luas pada kulit sehingga menyebabkan bakteri mudah berkoloni dan menjadi patogen pada kulit. Pasien diberikan terapi metilprednisolon, kotrimoksazole, chlorpheneramin maleat, perawatan luka dengan kompres NaCl 0,9%, serta salep gentamisin 0,1%. Pada pengamatan nampak perbaikan klinis pada pasien.

Kesimpulan: Diagnosis dan tatalaksana pemfigus vulgaris harus dilakukan dengan hati-hati dan pasien memiliki risiko infeksi sekunder yang tinggi sehingga tatalaksana pencegahan atau pengobatan infeksi harus selalu dipertimbangkan.

Keywords: pemfigus vulgaris bula tanda Nikolsky Gram Staphylococcus aureus

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How to Cite

Nukana, R. P., Ida Sri Iswari, & I Gusti Nyoman Darmaputra. (2022). Satu kasus Staphylococcus aureus sebagai agen penyebab infeksi sekunder kutaneus pada pemfigus vulgaris. Medicina, 53(1), 1–6. https://doi.org/10.15562/medicina.v53i1.976
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Ratih Purnamasari Nukana
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Medicina Journal

Ida Sri Iswari
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I Gusti Nyoman Darmaputra
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Medicina Journal