ANALISIS PEMERIKSAAN LABORATORIUM PADA KASUS LEPTOSPIROSIS DISERTAI ABSES HATI AMOEBA
DOI:
https://doi.org/10.36341/cmj.v3i3.1657Keywords:
abses hati amoeba, leptospirosis, pemeriksaan laboratoriumAbstract
Leptospirosis merupakan penyakit yang disebabkan mikroorganisme spirochaeta genus Leptospira sedangkan abses hepar amoeba merupakan komplikasi ekstraintestinal oleh Entamoeba Histolytica. Kedua penyakit terjadi pada seorang pria 45 tahun dengan sanitasi diri dan lingkungan yang kurang. Abses hepar amoeba ditemukan sebagai koinsiden yang diperkirakan telah ada sebelum pasien mengalami leptospirosis sehingga kedua penyakit tersebut menimbulkan manifestasi klinis yang tumpang tindih pada pasien, namun gejala akut yang dialami pasien pada saat datang ke rumah sakit lebih besar kemungkinan disebabkan oleh leptospirosisnya. Pasien mengeluh demam tinggi, kulit dan mata menguning, buang air kecil seperti teh pekat, pegal pada kedua kaki, mual, muntah dan nyeri ulu hati. Pada pemeriksaan fisik ditemukan febris, takikardia, iketrik pada kulit dan sklera, injeksi siliar, dan hepatomegali. Pemeriksaan laboratorium menunjukkan anemia ringan dengan gambaran normositik normokrom, leukositosis dengan neutrofilia shift to the right, trombositosis, LED meningkat, APTT memanjang, hiperbilirubinemia, peningkatan enzim SGOT SGPT, ALP, serta GGT, hipoalbuminemia, hiperglobulinemia, dan bilirubinuria. Pemeriksaan mikroskopis dengan pewarnaan negatif pada sampel urine ditemukan Leptospira. Pemeriksaan USG abdomen menunjukkan space occupying lesion (SOL) soliter pada lobus kanan hati dan pada pemeriksaan serologi diperoleh antiamoeba positif. Berdasarkan hal diatas, maka pasien ini didagnosis mengalami leptospirosis koinsiden dengan abses hati amoeba.
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