ULKUS GENITAL ET CAUSA HERPES GENITALIS PADA PASIEN GERIATRI IMUNOKOMPROMI DENGAN KEGANASAN PARU
DOI:
https://doi.org/10.33820/mdvi.v53i1.604Keywords:
herpes genitalis, ulkus genital, asiklovir, imunokompromiAbstract
Pendahuluan: Herpes genitalis pada pasien geriatri imunokompromi kerap bermanifestasi atipikal, meningkatkan risiko misdiagnosis. Tujuan laporan kasus ini adalah untuk mengetahui dan memahami manifestasi klinis, alur diagnosis, serta menekankan pentingnya terapi antivirus sistemik yang adekuat dan edukasi komprehensif sebagai pilar utama dalam penatalaksanaan herpes genitalis terutama pada pasien geriatri dan keganasan. Kasus: Tn. P (60 tahun) dengan tumor paru kanan stadium lanjut (manifestasi sesak, massa paru, dan metastasis hepar), dikonsulkan akibat ulkus genital nyeri. Pemeriksaan fisik menunjukkan ulkus multipel berbatas tegas pada penis. Meski apus Tzanck negatif, diagnosis herpes genitalis ditegakkan berdasarkan gambaran klinis khas pada imunokompromi dan dikonfirmasi melalui respons penyembuhan signifikan pasca-terapi asiklovir, menyingkirkan diagnosis banding ulkus mole. Diskusi: Penuaan menyebabkan immunosenescence yang melemahkan respons seluler terhadap virus. Kondisi ini diperberat oleh supresi imun sistemik akibat keganasan paru, memicu reaktivasi HSV dengan presentasi klinis atipikal (seperti ulkus tanpa vesikel) dan menurunkan sensitivitas pemeriksaan penunjang standar. Simpulan: Terdapat hubungan erat antara penurunan imunitas pada usia tua dan keganasan paru dengan kejadian, atipikalitas gejala, dan tantangan diagnostik herpes genitalis.
Downloads
References
DAFTAR PUSTAKA
1. Johnston C, Wald A. Genital Herpes. JAMA. 2024 Sep 10;332(10):835.
2. Biswas A, Kansal V. Herpes virus and its manifestations. In: Viral, Parasitic, Bacterial, and Fungal Infections. Elsevier; 2023. p. 125–36.
3. Zhu S, Viejo-Borbolla A. Pathogenesis and virulence of herpes simplex virus. Virulence. 2021 Dec 31;12(1):2670–702.
4. Johnston C. Diagnosis and Management of Genital Herpes: Key Questions and Review of the Evidence for the 2021 Centers for Disease Control and Prevention Sexually Transmitted Infections Treatment Guidelines. Clinical Infectious Diseases. 2022 Apr 13;74(Supplement_2):S134–43.
5. Spicknall IH, Flagg EW, Torrone EA. Estimates of the Prevalence and Incidence of Genital Herpes, United States, 2018. Sex Transm Dis. 2021 Apr;48(4):260–5.
6. Plagens-Rotman K, Przybylska R, Gerke K, Adamski Z, Czarnecka-Operacz M. Genital herpes as still significant dermatological, gynaecological and venereological problem. Advances in Dermatology and Allergology. 2021;38(2):210–3.
7. Bermúdez‐Rodríguez SP, Malagón‐Liceaga A, Figueroa‐Ramos G, Estrada‐Caraveo Y V., Gatica‐Torres M, Domínguez‐Cherit J. Genital ulcers in hospitalized patients: How often is genital herpes the culprit? JEADV Clinical Practice. 2024 Dec 4;3(5):1529–36.
8. AlMukdad S, Harfouche M, Farooqui US, Aldos L, Abu-Raddad LJ. Epidemiology of herpes simplex virus type 1 and genital herpes in Australia and New Zealand: systematic review, meta-analyses and meta-regressions. Epidemiol Infect. 2023 Feb 8;151:e33.
9. AlMukdad S, Harfouche M, Wettstein A, Abu-Raddad LJ. Epidemiology of herpes simplex virus type 2 in Asia: A systematic review, meta-analysis, and meta-regression. Lancet Reg Health West Pac. 2021 Jul;12:100176.
10. Cao G, Liu ; Jue, Liu M, Liang W. Preplanned Studies Global, Regional, and National Trends Analysis in Incidence of Genital Herpes Among the Population Aged 15-49 Years-Worldwide, 1990-2021.
11. Effendi A, Silvia E, Hamzah S, Ridhwan MA. Pola Penyakit Infeksi Menular Seksual di Poliklinik Kulit Dan Kelamin RSP Bintang Amin Periode 2 Januari 2016 – 31 Desember 2020. ARTERI : Jurnal Ilmu Kesehatan. 2021 Apr 17;2(2):43–8.
12. Alifa D. Herpes Genitalis pada Kehamilan. Indonesian Journal of Obstetrics & Gynecology Science.
13. Damour A, Garcia M, Seneschal J, Lévêque N, Bodet C. Eczema Herpeticum: Clinical and Pathophysiological Aspects. Clin Rev Allergy Immunol. 2020 Aug 13;59(1):1–18.
14. Borase H, Shukla D. The Interplay of Genital Herpes with Cellular Processes: A Pathogenesis and Therapeutic Perspective. Viruses. 2023 Oct 31;15(11):2195.
15. Zhu J, Miner MD. Local Power: The Role of Tissue-Resident Immunity in Human Genital Herpes Simplex Virus Reactivation. Viruses. 2024 Jun 25;16(7):1019.
16. Van Wagoner N, Qushair F, Johnston C. Genital Herpes Infection. Infect Dis Clin North Am. 2023 Jun;37(2):351–67.
17. Volpi A, Stanberry L. Genital Herpes: Clinical and Scientific Novelties. In: Sexually Transmitted Infections. Cham: Springer International Publishing; 2020. p. 223–31.
18. Wilson M, Wilson PJK. Genital Herpes. In: Close Encounters of the Microbial Kind. Cham: Springer International Publishing; 2021. p. 405–14.
19. Schremser V, Antoniewicz L, Tschachler E, Geusau A. Polymerase chain reaction for the diagnosis of herpesvirus infections in dermatology. Wien Klin Wochenschr. 2020 Jan 9;132(1–2):35–41.
20. López-Muñoz AD, Rastrojo A, Martín R, Alcamí A. Herpes simplex virus 2 (HSV-2) evolves faster in cell culture than HSV-1 by generating greater genetic diversity. PLoS Pathog. 2021 Aug 26;17(8):e1009541.
21. Yamamoto T, Aoyama Y. Detection of multinucleated giant cells in differentiated keratinocytes with herpes simplex virus and varicella zoster virus infections by modified Tzanck smear method. J Dermatol. 2021 Jan 17;48(1):21–7.
22. Cunha Ramos M, Nicola MRC, Bezerra NTC, Sardinha JCG, Sampaio de Souza Morais J, Schettini AP. Genital ulcers caused by sexually transmitted agents. An Bras Dermatol. 2022 Sep;97(5):551–65.
23. Ahmed J, Rawre J, Dhawan N, Dudani P, Khanna N, Dhawan B. Genital ulcer disease: A review. J Family Med Prim Care. 2022 Aug;11(8):4255–62.
24. Morrone A. Donovanosis, Chancroid, and Endemic Treponematoses: Clinical Features and Control. In: Sexually Transmitted Infections. Cham: Springer International Publishing; 2020. p. 319–35.
25. Chaudhry S, Akinlusi I, Shi T, Cervantes J. Secondary Syphilis: Pathophysiology, Clinical Manifestations, and Diagnostic Testing. Venereology. 2023 Apr 11;2(2):65–75.
26. Kłysik K, Pietraszek A, Karewicz A, Nowakowska M. Acyclovir in the Treatment of Herpes Viruses – A Review. Curr Med Chem. 2020 Jul 7;27(24):4118–37.
27. Patel R, Moran B, Clarke E, Geretti AM, Lautenschlager S, Green J, et al. 2024 European guidelines for the management of genital herpes. Journal of the European Academy of Dermatology and Venereology. 2025 Apr 2;39(4):742–58.
28. Workowski KA, Bachmann LH, Chan PA, Johnston CM, Muzny CA, Park I, et al. Sexually Transmitted Infections Treatment Guidelines, 2021. MMWR Recommendations and Reports. 2021 Jul 23;70(4):1–187.
29. Magdaleno-Tapial J, Hernández-Bel P, Valenzuela-Oñate C, Ortiz-Salvador JM, García-Legaz-Martínez M, Martínez-Domenech Á, dkk. Genital Infection With Herpes Simplex Virus Type 1 and Type 2 in Valencia, Spain: A Retrospective Observational Study. Actas Dermo-Sifiliográficas (English Edition). 2020 Jan;111(1):53–8.
30. Wilms L, Weßollek K, Peeters TB, Yazdi AS. Infections with Herpes simplex and Varicella zoster virus. JDDG: Journal der Deutschen Dermatologischen Gesellschaft. 2022 Oct 2;20(10):1327–51.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Seno Lamsir, Prasetyadi Mawardi, Endra Yustin Ellistasari, Pratiwi Prasetya Primisawitri
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
