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ISM (Intisari Sains Medis) : Jurnal Kedokteran

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Published by Universitas Udayana

ISSN : 25033638 EISSN : - DOI : -

Core Subject : Health, Science,

Biochemistry, Genetics & Molecular Biology Medicine & Pharmacology

Intisari Sains Medis is published by Medical Scientific Community, Indonesia. Intisari Sains Medis is an international, multidisciplinary, peer-reviewed, open access journal accepts papers for publication in all aspects of Science Digest, Medical Research Development, Research Medical Field and Theory. We also publish cases from third world country, that is considered very rare and special cases.

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Search results for , issue "Vol. 12 No. 3 (2021): (Available online: 1 December 2021)" : 68 Documents clear

Physical activity and vasomotor symptoms in perimenopausal women at Wukirsari Village, Yogyakarta, Indonesia Iwi Liesdiyanata; Dicky Moch Rizal; Djaswadi Dasuki
Intisari Sains Medis Vol. 12 No. 3 (2021): (Available online: 1 December 2021)
Publisher : DiscoverSys Inc.

Background: Menopause is an event that marks the end of the reproductive phase of a woman. Vasomotor symptoms are one of the primary symptoms of menopausal women and affect about 40-60% of perimenopausal women. This research aims to investigate the relationship of physical activity with vasomotor symptoms in perimenopausal women.Methods: The population in this study were 173 women aged 45-54 years who are still experiencing menstruation in the Wukirsari village working area of Puskesmas Cangkringan Sleman-Yogyakarta. The instrument for measuring vasomotor symptoms adopted two questions from the menopause rating scale (hot flushes and night sweats) questionnaire while measuring physical activity using a questionnaire from Riskesdas. Data were analyzed using SPSS version 23 for Windows.Results: Most of the participants were in the 45-50 years age group (75.73%), followed by severe vasomotor symptoms (95.95%), sufficient physical activity (91.91%), medium level education (49.71%), and informal occupation (94.80%). In addition, this study found that most of the participants were normal Body Mass Index (BMI) (54.34%), passive smoking (64.74%), and pre-hypertension (46.20%). There was a significant relationship between physical activities and BMI to the vasomotor symptoms among women of perimenopausal age (p<0.05).Conclusion: There was a significant relationship between physical activities and BMI the vasomotor symptoms among women of perimenopausal age.

Pengukuran Interleukin-6 (IL-6), C-Reactive Protein (CRP) dan D-Dimer sebagai prediktor prognosis pada pasien COVID-19 gejala berat: sebuah tinjauan pustaka I Ketut Wardika; I Gusti Putu Hery Sikesa
Intisari Sains Medis Vol. 12 No. 3 (2021): (Available online: 1 December 2021)
Publisher : DiscoverSys Inc.

Background: Patients with severe symptoms of Coronavirus disease-19 (COVID-19) experience a cytokine storm and coagulopathy that contribute to increased mortality requires a clinical parameter that is useful for risk stratification of COVID-19 patients. This literature review will discuss further the role of measuring D-Dimer, CRP and IL-6 levels as predictors of severe COVID-19 symptoms and prognostic predictors in severe COVID-19 patients.Methods: This literature review involved the relevant literature on CRP, IL-6, D-dimer and COVID-19. Different data sources or manual literature search methods were used to search for articles related to the literature topic.Results: In COVID-19, severe hyperinflammatory response cytokine storm symptoms were characterized by the release of excessive proinflammatory cytokines such as IL-6 and an increase in CRP as an acute phase reactant. In addition, there is also a coagulopathy condition which is characterized by an increase in D-dimer. There were significant differences in CRP, IL-6 and D-dimer levels between COVID-19 patients with mild and severe symptoms. levels of CRP, IL-6 and D-dimer also showed a significant relationship with increased severity and mortalityConclusion: Measurement of CRP, IL-6 and D-dimer levels is useful for predicting the occurrence of severe COVID-19 symptoms and a prognostic predictor in patients with severe COVID-19 symptoms. Latar Belakang: Pasien Coronavirus disease-19 (COVID-19) gejala berat mengalami badai sitokin dan koagulopati yang berkontribusi terhadap tingginya angka mortalitas. Diperlukan suatu parameter klinis yang berguna untuk stratifikasi risiko pasien COVID-19. Tinjauan pustaka ini akan membahas lebih lanjut mengenai peran pengukuran kadar D-Dimer, CRP dan IL-6 sebagai prediktor terjadinya COVID-19 gejala berat dan prediktor prognostik pada pasien COVID-19 gejala berat.Metode: Tinjauan pustaka ini melibatkan literatur yang relevan tentang CRP, IL-6, D-dimer dan COVID-19. Sumber data yang berbeda atau metode pencarian literatur manual digunakan untuk mencari artikel yang berkaitan dengan topik literatur.Hasil: Pada infeksi COVID-19 gejala berat terjadi badai sitokin akibat respon hiperinflamasi ditandai dengan dilepasnya sitokin pro-inflamasi berlebih seperti IL-6 serta peningkatan CRP sebagai reaktan fase akut. Selain itu terjadi pula kondisi koagulopati yang ditandai dengan peningkatan D-dimer. Terdapat perbedaan kadar CRP, IL-6 dan D-dimer yang signfikan antara pasien COVID-19 dengan gejala ringan dan gejala berat. Peningkatan kadar CRP, IL-6 dan D-dimer juga menunjukkan hubungan signifikan dengan peningkatan keparahan infeksi serta mortalitasSimpulan: Pengukuran kadar CRP, IL-6 dan D-dimer bermanfaat sebagai prediktor terjadinya COVID-19 gejala berat dan prediktor prognostik pada pasien COVID-19 gejala berat.

Hemolytic anemia in a 2-years old caused by Glucose 6 Phosphate Dehydrogenase Deficiency (G6PD): a case report Paulus Arief Budiman; Ketut Ariawati; Anak Agung Ngurah Ketut Putra Widnyana
Intisari Sains Medis Vol. 12 No. 3 (2021): (Available online: 1 December 2021)
Publisher : DiscoverSys Inc.

Background: Glucose-6-Phosphate-Dehydrogenase (G6PD) deficiency is an enzyme abnormality related to sex chromosomes (x-linked), which is inherited. The activity or stability of the G6PD enzyme decreases, thus causing the breakdown of red blood cells when an individual is exposed to exogenous substances that can cause oxidative damage. This case study aims to describe a rare case of hemolytic anemia caused by glucose 6 phosphate dehydrogenase deficiency in a two-year-old boy. Case Presentation: A two-year-old boy presented with agitated, pale, yellowish eyes and body and projectile vomiting after consuming fava beans. He had a prior history of packed red cell transfusion. Physical examination found the conjunctivae were pale with the icteric sclera. Laboratory examination revealed leukocytosis, moderate normochromic normocytic anemia, increased reticulocytes count, and elevated total and unconjugated bilirubin. Peripheral blood smear examination found microcytes, spherocytes, fragmentocytes, and burr cells. Coomb test was negative with decreased G6PD result. Conclusion: G6PD deficient patients have no symptoms until exposed to oxidizing drugs, infections or after fava beans ingestion which may cause hemolytic anemia and jaundice. Several methods of screening and diagnosis of G6PD can be performed to avoid morbidity and mortality.

Hubungan derajat leukopenia terhadap tingkat keparahan penyakit Demam Berdarah Dengue (DBD) pada pasien anak yang dirawat di Ruang Kaswari RSUD Wangaya, Denpasar, Indonesia Erica Lidya Yanti; I Wayan Bikin Suryawan; Made Widiasa
Intisari Sains Medis Vol. 12 No. 3 (2021): (Available online: 1 December 2021)
Publisher : DiscoverSys Inc.

Background: Dengue Hemorrhagic Fever (DHF) still becomes a public health problem in Indonesia even in the world. DHF is caused by the dengue virus with various clinical manifestations such as fever, bleeding manifestations and circulatory failure as well. One of the risk factors of severe dengue infection is leukopenia. This study aims to determine the relationship between the degree of leukopenia and the severity of DHF in pediatric patients treated in the Kaswari room of Wangaya Hospital, Denpasar.Methods: The research was conducted from December 2018 until February 2019 with a cross-sectional analytical method. The subjects of research were children with DHF, admitted in the Wangaya Hospital and fulfilled the inclusion and exclusion criteria. 58 samples were obtained by using consecutive sampling methods. Data were analyzed using SPSS version 21 for Windows.Results: Most of the respondents with DHF were known to be > 10 years old, both in the shock group (52.9%) and without shock (48.8%). The dominant sex was male (77.4%) in the shock group while female (62.7%) in the group without shock. There was a significant difference between the degree of leukopenia and the severity of DHF (RP=4.29; 95% CI=1.58-11.57; p=0.003) in this study.Conclusion: There is a significant association between the degree of leucopenia especially with leukocyte value of <5000/Ul and the severity of dengue hemorrhagic fever especially DHF with shock. Latar Belakang: Demam Berdarah Dengue (DBD) hingga saat ini masih menjadi masalah kesehatan baik di dunia maupun di Indonesia. DBD disebabkan oleh virus dengue dengan beragam manifestasi klinis, diantaranya adakah demam, manifestasi perdarahan hingga kegagalan sirkulasi darah. Salah satu faktor resiko dari infeksi dengue berat adalah leukopenia. Penelitian ini bertujuan untuk mengetahui hubungan derajat leukopenia terhadap tingkat keparahan penyakit DBD pada pasien anak yang dirawat di ruang Kaswari RSUD Wangaya kota Denpasar.Metodologi: Penelitian ini menggunakan metode analitik potong lintang yang dilakukan pada bulan Februari 2019. Penelitian ini melibatkan anak dengan DBD yang dirawat di ruang Kaswari RSUD Wangaya kota Denpasar mulai 1 Desember 2018 sampai 28 Februari 2019. Pengambilan sampel menggunakan metode consecutive sampling. Sampel yang memenuhi kriteria inklusi dan eksklusi adalah 58 sampel. Data dianalisis dengan SPSS versi 21 untuk Windows.Hasil: Sebagian besar responden dengan DBD diketahui berusia > 10 tahun baik pada kelompok syok (52,9%) maupun tanpa syok (48,8%). Jenis kelamin laki-laki dominan (77,4%) pada kelompok syok sedangkan perempuan (62,7%) pada kelompok tanpa syok. Terdapat perbedaan yang bermakna antara derajat leukopenia dengan tingkat keparahan DBD (RP=4,29; 95%IK=1,58-11,57; p=0.003) pada penelitian ini.Kesimpulan: Terdapat hubungan yang bermakna antara derajat leukopenia khususnya pada nilai leukosit <5000/Ul terhadap tingkat keparahan demam berdarah dengue khususnya DBD dengan syok.

The relationship between nutritional status, severity of diarrhea, and length of stay among pediatric patients with diarrhea in Wangaya Regional General Hospital Mayland Margaretha Sunata; I Wayan Bikin Suryawan; Anak Agung Made Widiasa
Intisari Sains Medis Vol. 12 No. 3 (2021): (Available online: 1 December 2021)
Publisher : DiscoverSys Inc.

Background: Diarrhea is a disease still often encountered in society and is one of the biggest causes of death in children. Many factors contributed to the process of diarrhea, including poor nutritional status. According to the data from Riskesdas in 2018, 17.7% of children under five in Indonesia still have nutritional problems. This study was conducted with the aim to know the relationship between nutritional status, the severity of diarrhea and the length of stay among pediatric patients with diarrhea.Methods: This analytical study uses a cross-sectional design, with a total of 87 samples. Pediatric patients in Kaswari room from January 2019 to July 2020 with diarrhea or gastroenteritis, whose body’s length or height, weight and duration of stay listed in the medical record were included in this study, while patients with congenital abnormality like Hirschsprung disease were excluded from this study. The data collected were analyzed using the Fisher test and Chi-square test.Results: Out of 87 children, 49 (56%) of them had normal nutritional status, 78 (87.4%) children had modified vesikari score ? 11, and 68 children had a length of stay < 5 days (78.2%). The results of bivariate analysis between nutritional status and diarrhea severity showed that there was no relationship between the two variables (p = 0.426). The same results were obtained in bivariate analysis between nutritional status and length of stay (p = 0.916).Conclusion: In this study, there was no relationship found between nutritional status, the severity of diarrhea and length of stay among pediatric patients with diarrhea in Wangaya Regional General Hospital.

Diagnosa dan Tatalaksana pada Hemoroid Derajat IV: Laporan Kasus Ni Nyoman Amik Indrayani; Agung Aditya Arnaya; Kevin Kristanto Wiguna; Ida Bagus Putu Wiyasa
Intisari Sains Medis Vol. 12 No. 3 (2021): (Available online: 1 December 2021)
Publisher : DiscoverSys Inc.

Background : Hemorrhoids affect millions of people around the world and become one of the main medical and socioeconomic problems Hemorrhoids are symptomatic widening of the hemorrhoidal plexus and distal displacement of the normal cushion. This case report aims to discuss cases of hemorrhoids from diagnosis to management.Case Report: A 30-year-old male came with complaints of fresh blood discharge during defecation. Complaints have been felt for 1 month ago and have worsened for 1 day before being admitted to the hospital. On local examination in the anal region, there was a mass with an irregular shape around the anal, some of which were blackish red in color and partly the same color as the surrounding skin with a diameter of 3 cm. On palpation, the mass was palpable, firm, tenderness, the mass could not be given with a finger. Based on the history and physical examination, the patient was diagnosed with grade IV internal hemorrhoids and an open hemorrhoidectomy (Miligan-Morgan method) was planned.Conclusion: The diagnosis of hemorrhoids is obtained from the patient's medical history, physical examination and supporting examinations. Therapeutic management of hemorrhoids can be in the form of animation and surgery. Latar Belakang : Hemoroid mengenai jutaan orang diseluruh dunia dan menjadi salah satu masalah medis utama dan masalah sosioekonomi Hemoroid adalah pelebaran simptomatis dari pleksus hemoroid dan pergeseran bantalan anus ke arah distal dari normal. Laporan kasus ini bertujuan untuk membahas kasus hemoroid dari diagnosa sampai dengan tatalaksananya.Laporan Kasus: Seorang laki-laki usia 30 tahun datang dengan keluhan keluar darah berwarna merah segar saat buang air besar. Keluhan dirasakan sejak 1 bulan yang lalu dan memberat sejak 1 hari sebelum masuk rumah sakit. Pada pemeriksaan lokalis di regio anal terlihat adanya benjolan dengan bentuk iregular mengitari anus yang sebagian berwarna merah kehitaman dan sebagian sama dengan warna kulit disekitarnya dengan ukuran diameter 3 cm. Saat dilakukan palpasi didapatkan benjolan teraba kenyal, batas tegas, nyeri tekan (+) benjolan tidak dapat dimasukkan dengan jari. Berdasarkan dari anamnesa dan pemeriksaan fisik, pasien kemudian didiagnosa dengan Hemorroid interna grade IV dan ditangani dengan metode open hemorrhoidectomy (Miligan-Morgan Method). Pasien dirawat selama dua hari dimana pasien sudah bisa buang air besar tetapi masih terasa nyeri namun benjolan sudah tidak terlihat dari anus.Simpulan: Hemoroid dapat didiagnosa dari riwayat medis pasien, pemeriksaan fisik serta pemeriksaan penunjang. Manajemen terapi pada hemoroid dapat berupa konservatif dan operasi.

Peran terapi mesenchymal stem cell (MSC) dalam penatalaksanaan luka bakar: sebuah tinjauan sistematis Zendio Abednego Santoso
Intisari Sains Medis Vol. 12 No. 3 (2021): (Available online: 1 December 2021)
Publisher : DiscoverSys Inc.

Background: Burn cases are still a challenge and a burden in the health sector due to the morbidity and mortality it causes. The current management of burns has not produced satisfactory clinical outcomes in terms of wound healing. Mesenchymal stem cell (MSC) therapy is known to have an effective curative effect in healing burns. This systematic review aims to determine the role of MSCs in the management of burns.Methods: A systematic literature review was carried out by searching the literature on Google Scholar, Pubmed and Cochrane Library, where the literature selection used PRISMA diagrams. The inclusion criteria used were studies in the form of clinical trials examining the role of MSCs in the management of thermal burns. The study was not a clinical trial, studies with research samples in the form of non-thermal burns, research subjects were not rats or mice, MSC was not used as the main intervention therapy, and did not involve the control group in the study were excluded so that 12 studies that met the eligibility criteria were obtained.Results: 12 studies carried out the synthetic analysis in randomized clinical trials using research subjects in the form of mice and rats. The MSC therapy was isolated from bone marrow, cord blood and adipose tissue. MSC therapy plays a role in accelerating the healing process of burns through several biomolecular mechanisms such as reducing apoptosis, suppressing inflammatory responses and oxidative stress, triggering angiogenesis, accelerating re-epithelialization and tissue remodeling. MSC therapy has also been shown to minimize the formation of contractures and scar tissue,Conclusion: The role of MSC therapy in burns is to accelerate the wound healing process, reduce the occurrence of contractures and scar tissue so that it is very potential to be applied in the management of burns. Latar Belakang Kasus luka bakar masih menjadi tantangan dan beban di bidang kesehatan akibat morbiditas dan mortalitas yang ditimbulkannya. Penatalaksanaan luka bakar saat ini belum mampu menghasilkan luaran klinis yang memuaskan dari segi penyembuhan luka. Terapi mesenchymal stem cell (MSC) diketahui memiliki efek kuratif yang efektif dalam proses penyembuhan luka bakar. Tujuan dari tinjauan pustaka sistematis ini adalah untuk mengetahui peranan MSC dalam penatalaksanaan luka bakar.Metode: Tinjauan pustaka sistematis dilakukan dengan pencarian literatur pada Google Scholar, Pubmed, dan Cochrane Library dimana pemilihan literatur menggunakan diagram PRISMA. Kriteria inklusi yang digunakan adalah studi berupa uji klinis yang meneliti peran MSC dalam tatalaksana luka bakar termal. Studi bukan berupa uji klinis, studi dengan sampel penelitian berupa luka bakar non-termal, subjek penelitian bukan berupa tikus atau mencit, MSC tidak digunakan sebagai terapi intervensi utama, serta tidak melibatkan kelompok kontrol dalam studinya dilakukan eksklusi sehingga didapatkan 12 studi yang memenuhi kriteria eligibilitas.Hasil: Terdapat 12 studi yang dilakukan analisis sintesis berupa uji klinis acak menggunakan subjek penelitian berupa mencit dan tikus. Terapi MSC yang digunakan diisolasi dari sumsum tulang belakang, darah tali pusat dan jaringan adiposa. Terapi MSC berperan mempercepat proses penyembuhan luka bakar melalui sejumlah mekanisme biomolekuler berupa mengurangi apoptosis, menekan respon inflamasi dan stress oksidatif, memicu angiogenesis, mempercepat re-epitelisasi, serta remodelling jaringan. Terapi MSC juga terbukti meminimalisir terbentuknya kontraktur dan jaringan parut,Simpulan: Peran terapi MSC dalam luka bakar adalah mempercepat proses penyembuhan luka, mengurangi terjadinya kontraktur dan jaringan parut sehingga sangat potensial untuk diaplikasikan dalam tatalaksana luka bakar.

Colonoscopy surveillance of colorectal cancer post-surgery in Sanglah General Hospital, Bali, Indonesia: a descriptive study Gede Eka Rusdi Antara
Intisari Sains Medis Vol. 12 No. 3 (2021): (Available online: 1 December 2021)
Publisher : DiscoverSys Inc.

Background: The postoperative surveillance of patients treated for colorectal cancer is intended to prolong survival by diagnosing recurrent and metachronous cancers at a curable stage as well as preventing metachronous cancer by detection and removal of precancerous polyps. This study evaluates the surveillance colonoscopy and its association with sociodemographic and clinical findings in a descriptive study.Methods: This is a cross sectional study of colorectal cancer patients who underwent surveillance colonoscopy as follow up after tumor resection from January 2020 to September 2021 in Sanglah General Hospital. Clinical data were gathered from medical records and databases by a qualified reviewer. Data were analyzed descriptively using SPSS version 20 for Windows.Results: The majority of patients who underwent surveillance colonoscopy were male (82.40%), tumor location at rectum (58.8%), stage IV (29.40%), underwent low anterior resection surgery (35.30%) and received Folfox (35.30%) or Capeox (35.30%) adjuvant chemotherapy. There was 2 (11.80%) residual mass found in this study. There was no significant difference between subjects who underwent surveillance colonoscopy with residual mass and without residual mass in all variables assessed (p>0.05).Conclusion: Colonoscopy surveillance plays an important role in early detection for any recurrence or pre-cancer lesion and metachronous cancer in a patient with colorectal malignancies in Sanglah General Hospital, Bali, Indonesia.

Diagnosis dan tatalaksana rinosinusitis maksilaris odontogenik yang meluas sampai etmoid dan frontal: laporan kasus Agus Santosa; Nyoman Dian Permata Sari; Ida Bagus Semara Putra; Dewa Ayu Putu Sri Masyeni
Intisari Sains Medis Vol. 12 No. 3 (2021): (Available online: 1 December 2021)
Publisher : DiscoverSys Inc.

Background: Sinusitis is an inflammatory process in the nasal mucosa, especially in the paranasal sinuses. Sinusitis problems are important and need special attention in cases of sinusitis that do not improve after being given conventional therapy. The purpose of this paper is to establish the diagnosis and management of odontogenic maxillary rhinosinusitis that extends to the ethmoid and frontal areas.Case presentation: A male patient, aged 22 years, came to the ENT clinic at Mangusada Hospital, Badung. Based on the history, physical examination, supporting examination in the form of CT-scan so that it was diagnosed as chronic rhinosinusitis et causa odontogenic which extends to the ethmoid and frontal. The treatment chosen was surgery in the form of Functional Endoscopic Sinus Surgery (FESS) and septorhinoplasty because in this case the patient had complications and did not respond to medical therapy. Postoperative evaluation, complaints of smelly mucus, nasal congestion and headache were not felt.Conclusion: The diagnosis of chronic rhinosinusitis et causa odontogenic which extends to the ethmoid and frontal based on CT-Scan and the treatment given to the patient in the form of FESS and septorhinoplasty. Latar belakang: Sinusitis merupakan proses inflamasi pada mukosa hidung, lebih khususnya pada sinus paranasal. Masalah sinusitis menjadi penting dan perlu perhatian khusus pada kasus sinusitis yang tidak membaik setelah diberikan terapi konvensional. Tujuan penulisan ini adalah untuk menegakkan diagnosis dan penatalaksan rinosinusitis maksilaris odontogenik yang meluas sampai etmoid dan frontal.Presentasi kasus: Seorang pasien laki-laki, berusia 22 tahun datang ke poli THT RS Mangusada, Badung. Berdasarkan anamnesis, pemeriksaan fisik, pemeriksaan penunjang berupa CT-scan sehingga didiagnosis sebagai rinosinusitis kronis et causa odontogenic yang meluas sampai etmoid dan frontal. Penatalaksanaan yang dipilih adalah pembedahan berupa Functional Endoscopic Sinus Surgery (FESS) dan septorhinoplasti, karena pada kasus ini pasien mengalami komplikasi dan tidak memberikan respon dengan terapi medikamentosa. Evaluasi pasca operasi, keluhan ingus berbau, hidung tersumbat dan nyeri kepala sudah tidak dirasakan.Kesimpulan: Diagnosis rinosinusitis kronis et causa odontogenic yang meluas sampai etmoid dan frontal berdasarkan dari CT-Scan dan tatalaksana yang diberikan pada pasien berupa FESS dan septorhinoplasti.

Diagnosis dan penatalaksanaan tuberkulosis sistem saraf pusat Prima Yogi; I Putu Andrika; I Gede Ketut Sajinadiyasa; I Made Bagiada
Intisari Sains Medis Vol. 12 No. 3 (2021): (Available online: 1 December 2021)
Publisher : DiscoverSys Inc.

Introduction: Central nervous system (CNS) tuberculous are the most dangerous form of extrapulmonary TB. CNS tuberculous can present as meningoencephalitis, intracranial tuberculomas, and vasculitis. CNS tuberculous accounts for about 1% of all TB cases and is associated with high mortality. Tuberculous meningoencephalitis commonly presents with classic symptoms of fever, headache, meningism (neck stiffness), seizures as well as focal neurologic deficits, and altered consciousness. The diagnosis and treatment of CNS tuberculosis is still a formidable clinical challenge.Case report: Patient presented with fever, headache, meningismus, convulsion, and decreased consciousness. CT scan showed cerebral tuberculoma in the left parietal lobe. Examination gene-Xpert of the cerebrospinal fluid showed Mycobacterium tuberculosis. The patient was given category 1 of anti-tuberculosis drugs.Conclusion: CNS tuberculosis has non-specific symptoms, difficult diagnosis, and high mortality. In this case report, the diagnosis of CNS tuberculosis was established based on the presence of Mycobacterium tuberculosis on the CSF molecular rapid test examination, and a CT scan of the head with contrast found cerebral tuberculoma.

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