LESI ATIPIKAL HERPES SIMPLEKS GENITALIS PADA PASIEN HUMAN IMMUNODEFICIENCY VIRUS STADIUM IV
DOI:
https://doi.org/10.33820/mdvi.v49i1.175Keywords:
herpes simpleks genitalis, HSV, HIV, lesi atipikalAbstract
Infeksi herpes simpleks genitalis akibat Herpes Simplex Virus (HSV) dapat berulang dan berlangsung seumur hidup. Infeksi HSV menjadi penyebab tersering dari ulkus genital pasien Human Immunideficiency Virus (HIV). Pasien HIV seringkali mengalami herpes simpleks genitalis dengan manifestasi yang atipikal, lebih berat dan lebih sering kambuh. Seorang perempuan berusia 30 tahun mengeluhkan luka di area kemaluan dan pantat sejak 1,5 bulan terakhir. Pasien terdiagnosis HIV stadium IV dan Tuberkulosis (TB) namun putus berobat. Pasien diterapi sebagai ulkus mole selama 1 minggu namun tidak ada perbaikan. Gambaran lesi atipikal yang didapatkan berupa ulkus luas multipel, dasar eritematosa, mudah berdarah, sangat nyeri dengan batas tegas dan tepi ireguler pada area inguinal dan gluteus. Hasil kultur tidak menunjukkan adanya Haemophilus Ducreyi dan hasil biopsi menyingkirkan diagnosis banding Donovanosis. Pemeriksaan laboratorium menunjukkan CD4 9 sel/μL dan peningkatan Anti HSV-2 IgG. Pasien tegak didiagnosis sebagai herpes simpleks genitalis, HIV stadium IV dan TB. Perbaikan bermakna didapatkan setelah terapi supresi Asiklovir 3 x 400 mg per hari selama 6 minggu. Pasien dengan lesi atipikal memerlukan pemeriksaan serologis dalam menegakkan diagnosis. Tatalaksana yang tepat dapat mencegah komplikasi dan rekurensi herpes simpleks genitalis pada pasien HIV.
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