EVALUASI PENGOBATAN SIFILIS SEKUNDER PADA DEWASA MUDA
DOI:
https://doi.org/10.31004/jkt.v6i2.45083Keywords:
Benzatin Penisilin G, Dewasa Muda, Evaluasi Pengobatan, Sifilis SekunderAbstract
Sifilis merupakan satu dari sekian banyak penyakit infeksi menular seksual yang bersifat kronik. WHO tahun 2022 melaporkan bahwa sekitar 8 juta orang dewasa terkena sifilis di seluruh dunia dalam rentang usia 15-29 tahun. Provinsi Papua Barat menempati peringkat ke-4 dengan prevalensi sifilis tertinggi di Indonesia pada tahun 2022, dengan 1.816 kasus positif. Penyakit ini ditransmisikan melalui hubungan seksual secara oral, vaginal ataupun anal, selama masa kehamilan dan transfusi darah. Interaksi kompleks antara ciri biologis unik T. pallidum dan respons imun inang menyebabkan infeksi sistemik dan manifestasi klinis berbagai tahap. Sifilis sekunder merupakan stadium yang paling krusial karena pengobatan menjadi sangat penting untuk mencegah perkembangan sifilis ke tahap yang lebih lanjut. Kasus ini menyoroti evaluasi pengobatan pada laki-laki berusia 26 tahun yang memiliki riwayat berhubungan seksual tanpa menggunakan alat kontrasepsi (kondom) dan sering berganti pasangan. Pasien terdiagnosa sifilis sekunder dengan manifestasi roseola sifilitika. Pasien diberikan tatalaksana berupa injeksi dosis tunggal benzatin penisilin G 2,4 juta unit secara intramuskular (IM) 1,2 juta unit pada bokong kanan dan kiri. Pasien juga direncanakan untuk dilakukan pemeriksaan serologis ulang pada bulan 1, 3, 6, 9 dan 12. Pasien dilakukan pemeriksaan serologi ulangan pada bulan 1 dan 3 setelah penyuntikan dan didapatkan penurunan titer RPR dari 1:128 menjadi 1:16, yang menunjukkan tolak ukur keberhasilan pengobatan.References
Centers for Disease Control and Prevention. (2023). Sexually Transmitted Infection Surveillance. CDC [Internet]. https://www.cdc.gov/sti-statistics/annual/slides.html
Centers for Disease Control and Prevention. (2015). The Diagnosis, Management and Prevention of Syphilis Pocket Guide. CDC [Internet]. https://targethiv.org/sites/default/files/file-upload/resources/01_02_20_syphilis_z_fold_pocket_guide__p7.pdf
Chaudhry, S., Akinlusi, I., Shi, T., & Cervantes, J. (2023). Secondary Syphilis: Pathophysiology, Clinical Manifestations, and Diagnostic Testing. Venereology, 2(2), 65-75. https://doi.org/10.3390/venereology2020006
CNN Indonesia. (2023). Sebaran Kasus Sifilis di Indonesia: Papua dan Jabar Terbanyak. CNN Indonesia [Internet]. https://www.cnnindonesia.com/nasional/20230512092735-20-948614/sebaran-kasus-sifilis-di-indonesia-papua-dan-jabar-terbanyak
Djuanda, A., Sudharmono, A., Novianto, E., Zubier, F., Rahmayunita, G., Cipto, H. (2016). Ilmu penyakit kulit dan kelamin. Jakarta: Fakultas Kedokteran Universitas Indonesia
Lyngdoh, C.J., Ramudamu, M., Agarwal, M., Verma, S., & Prasad, A. (2024). Evaluation of Serological Tests for the Diagnosis of Syphilis. Cureus, 16(5), e61007. https://doi.org/10.7759/cureus.61007
Holman, K.M., Wolff, M., Seña, A.C., Martin, D.H., Behets, F., … & Hook, E.W 3rd. (2012). Rapid plasma reagin titer variation in the 2 weeks after syphilis therapy. Sexually transmitted diseases, 39(8), 645–647. https://doi.org/10.1097/OLQ.0b013e3182536574
Hook, E.W. (2017). Syphilis. The Lancet, 389(10078), 1550-1557. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)32411-4/abstract
Janier, M., Unemo, M., Dupin, N., & Tiplica, G. S. (2020). 2020 European guideline on the management of syphilis. Journal of the European Academy of Dermatology and Venereology, 35(3), 574–588. https://doi.org/10.1111/jdv.16946
Kementerian Kesehatan Republk Indonesia Direktorat Jendral Pencgahan dan Pengendalian Penyakit Menular. (2021). Laporan Perkembangan HIV AIDS & Penyakit Infeksi Menular Seksual. Jakarta: Kemenkes RI
Menaldi, S.L., Bramono, K., Indriatmi, W. (2015). Ilmu Penyakit Kulit dan Kelamin. Jakarta: Fakultas Kedokteran Universitas Indonesia
Mustikawati, D.E., Morineau, G., Nurhayati., Irmaningrum, Y., Riono, P., Priohutomo, S., Magnani, R. (2009). Sexual risk taking, sexually transmitted infections and HIV prevalence among four :high risk” occupational groups of Indonesian men. Sexually Transmitted Infections, 85(5), 391-6. https://www.researchgate.net/publication/24188803_Sexual_risk_taking_sexually_transmitted_infections_and_HIV_prevalence_among_four_high-risk''_occupational_groups_of_Indonesian_men
Newell, G., Patel R. (2019). Syphilis (primary syphilis, latent syphilis, cardiovascular syphilis, secondary syphilis, tertiary syphilis, neurosyphilis). Dermatology Advisor [Internet]. https://www.dermatologyadvisor.com/home/decision-support-in-medicine/dermatology/syphilis-primary-syphilis-latent-syphilis-cardiovascular-syphilis-secondary-syphilis-tertiary-syphilis-neurosyphilis/
Pan American Health Oragnization. (2024). Syphilis cases increase in the Americas. PAHO [Internet]. https://www.paho.org/en/news/22-5-2024-syphilis-cases-increase-americas
Perhimpunan Dokter Spesialis Kulit dan Kelamin Indonesia [PERDOSKI]. (2021). Panduan Praktik Klinis Bagi Dokter Spesialis Dermatologi dan Venereologi Indonesia. Jakarta: PERDOSKI
Peterman, T. A., Su, J., Bernstein, K. T., & Weinstock, H. (2015). Syphilis in the United States: on the rise?. Expert review of anti-infective therapy, 13(2), 161–168. https://doi.org/10.1586/14787210.2015.990384
Refugio, O.N., & Klausner, J.D. (2018). Syphilis incidence in men who have sex with men with human immunodeficiency virus comorbidity and the importance of integrating sexually transmitted infection prevention into HIV care. Expert review of anti-infective therapy, 16(4), 321–331. https://doi.org/10.1080/14787210.2018.1446828
Romanowski, B., Sutherland, R., Fick, G. H., Mooney, D., & Love, E. J. (1991). Serologic response to treatment of infectious syphilis. Annals of internal medicine, 114(12), 1005–1009. https://doi.org/10.7326/0003-4819-114-12-1005
Terzi, H., Aydemir, O., Karakece, E., Hatipoglu, H., Olmez, M., … & Altindis, M. (2020). Investigation of the rapid immunochromatographic test performance in the diagnosis of syphilis; comparison of four serological methods. Journal of Laboratory Medicine, 44(4), 221-226. https://doi.org/10.1515/labmed-2019-0012
Tudor, M.E., Al Aboud, A.M., Leslie, S.W., Gossman, W. (2024). Syphilis. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Available from: https://www.ncbi.nlm.nih.gov/books/NBK534780/
World Health Organization [WHO a]. (2024). Syphilis. WHO [Internet]. https://www.who.int/news-room/fact-sheets/detail/syphilis
World Health Organization [WHO b]. (2024). Updated recommendations for the treatment of Neisseria gonnorrhoeae, Chlamydia trachomatis and Treponema pallidum (syphilis), and new recommendations on syphilis testing and partner services. WHO [Internet]. https://www.who.int/publications/i/item/9789240090767
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