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All Journal Indian Journal of Forensic Medicine & Toxicology
Wibisono Nugraha
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Hemorrhagic Varicella in a 41-Year-Old Woman with Evans Syndrome : Case Report Alfina Rahma; Eka Devinta Novi Diana; Frieda; Wibisono Nugraha; Muhammad Eko Irawanto; Moerbono Mochtar
Indian Journal of Forensic Medicine & Toxicology Vol. 16 No. 1 (2022): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v16i1.17445

Abstract

Background: Varicella is an infection caused by the varicella-zoster virus (VZV) with symptomsof an exanthematous vesicular rash and systemic symptoms. Hemorrhagic varicella commonlyseen in immunocompromised patients. Evans syndrome (ES) is an autoimmune with two or morecytopenias,including autoimmune hemolytic anemia (AIHA) and immune thrombocytopenia (ITP).Case: 41-year-old woman complains of swelling filled with reddish fluid almost all over herbody,sometimes painful and accompanied by fever. Patient also experienced vaginal bleeding resultingin anemia (Hb 8.8 g/DL) and thrombocytopenia (platelets 34,000/uL). Dermatological status of thegeneralized,multiple hemorrhagic vesicles with an erythematous base,partially ruptured. Tzank testrevealed multinucleated giant cells. Patient suffered AIHA and received therapy with methylprednisolone4 mg/day and mycophenolic acid 2x500 mg/day.Conclusion: We report a case of hemorrhagic varicella in a 41-year-old woman with Evan’s syndromewith concurrent features of AIHA and ITP. Dermatological status of the generalized, multiplehemorrhagic vesicles with an erythematous base,some of ruptured with erosions. Tzank test revealedmultinucleated giant cells. Patient was treated with acyclovir 5x800 mg for 7 days,2% salicylic acid and0.5% menthol applied every 12 hours and mupirocin 2% ointment applied twice a day on the erosionarea and clinical improvement was found after 17 days of therapy.
Secondary Syphilis in the Second Trimester Pregnancy : Case Report Wibisono Nugraha; Eka Devinta Novi Diana; Frieda; Alfina Rahma; Prasetyadi Mawardi
Indian Journal of Forensic Medicine & Toxicology Vol. 16 No. 1 (2022): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v16i1.17670

Abstract

Background: Syphilis is a sexually transmitted disease caused by Treponema pallidum, which is transmitted through sexual contact, blood transfusion and transplacental from an infected mother to the fetus. Syphilis in pregnancy can cause complications including abortion, low birth weight, premature birth, neonatal death or congenital syphilis infection.Case: A 39-year-old woman, 16 weeks pregnant, presented with a complaint of a small lump on the genitals accompanied by red patches on the palms of the hands and feet. Serological tests showed a reactive VDRL of 1:512 and a reactive TPHA of 1:640. Based on the history, physical examination and serological tests the patient was diagnosed with secondary syphilis in pregnancy. The management of this patient was given a single dose of Benzathine Penicillin G injection of 2.4 million units intramuscularly.Conclusion: Early screening for syphilis in pregnancy isvery important to prevent complications in the fetus. VDRL serological test examination 3 months after therapy was carried out to determine the success of therapy. In this case, there was a decrease in the VDRL titer to 1:4 in the absence of skin lesions 3 months after therapy with benzathine penicillin G 2.4 million units intramuscularly single dose.
Co-Authors Alfina Rahma Eka Devinta Novi Diana Frieda Moerbono Mochtar Muhammad Eko Irawanto Prasetyadi Mawardi