HIV DENGAN TB PARU DAN PNEUMOCYSTIC JIROVECII PNEUMONIAE : LAPORAN KASUS
DOI:
https://doi.org/10.31004/prepotif.v9i2.48069Keywords:
HIV, pneumocystic jirovecii pneumoniae, TB paruAbstract
Infeksi Human Immunodeficiency Virus (HIV) merupakan masalah kesehatan global yang menyebabkan penurunan sistem imun dan meningkatkan kerentanan terhadap infeksi oportunistik, seperti tuberkulosis (TB) dan Pneumocystis jirovecii pneumonia (PJP). Indonesia saat ini menjadi salah satu negara dengan beban TB tertinggi di dunia, dan koinfeksi HIV-TB menambah kompleksitas tatalaksana klinis. PJP juga menjadi infeksi oportunistik dengan mortalitas tinggi pada pasien HIV dengan imunosupresi berat. Penulisan ini bertujuan untuk mendeskripsikan proses diagnostik dan penatalaksanaan pada pasien dengan koinfeksi TB paru, HIV, dan PJP. Metode yang digunakan adalah laporan kasus deskriptif terhadap seorang perempuan berusia 39 tahun dengan gejala sesak napas, batuk berdahak, penurunan berat badan, dan hasil penunjang yang menunjukkan koinfeksi. Data diperoleh melalui anamnesis, pemeriksaan fisik menyeluruh, pemeriksaan laboratorium, radiologi (foto toraks dan CT-scan), serta pemeriksaan mikrobiologi dan imunologi. Diagnosis ditegakkan sebagai TB paru kasus baru, HIV reaktif dengan kadar CD4 27/μL, dan PJP berdasarkan temuan radiologis serta identifikasi kista Pneumocystis jirovecii. Penatalaksanaan diberikan secara multidisipliner menggunakan antibiotik, steroid, mukolitik, serta terapi suportif lainnya. Koinfeksi TB-HIV-PJP memperlihatkan hubungan patofisiologis yang saling memperburuk, menyebabkan penurunan imunitas lebih lanjut dan meningkatkan risiko kematian. Pemahaman mendalam tentang interaksi patogen dan penanganan tepat waktu sangat penting dalam memperbaiki prognosis pasien. Kasus ini menekankan pentingnya pendekatan holistik dan berbasis bukti dalam menangani pasien HIV dengan infeksi oportunistik multipel.References
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