Empiema Necessitans Akibat Infeksi Tuberkulosis Yang Ditatalaksana Dengan Pembedahan: Laporan Kasus Dan Tinjauan Pustaka

Amelinda Fortuna Dewi, Fauzi Abdillah, Arif Prasetyo Utomo, Darmawan Ismail

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Empiema necessitans (EN) adalah konsekuensi yang sangat jarang terjadi dari infeksi pleura yang tidak diobati. Ini terjadi ketika empiema yang tidak diobati melalui pleura parietal dan membentuk abses di jaringan subkutis pada dinding dada. Respons segera diperlukan untuk menghindari morbiditas yang signifikan. Di sini kami sajikan seorang wanita berusia 51 tahun dengan pembengkakan lunak di dinding dada posterior kanan bawah. Rontgen dada dan Computed Tomography (CT) thorax menunjukkan adanya abses paru dan empiema necessitan di lobus inferior paru kanan, kami menemukan empiema intraoperatif. Pasien diobati dengan sayatan kecil dan drainase; namun, kondisinya tetap tidak terselesaikan. Perawatan dilanjutkan dengan dekortikasi torakotomi sebagai drainase dan debridemen jaringan yang terinfeksi serta eskalasi antibiotik. Selang dada dilepas dan pasien dipulangkan pada hari ke-5 pasca operasi setelah menunjukkan perbaikan klinis. Tes GeneXpert® telah dilakukan dan mengkonfirmasi bahwa M. tuberculosis adalah penyebabnya. EN jarang ditemukan sebagai satu-satunya infeksi pada paru-paru dan pleura. Diagnosis yang akurat berdasarkan temuan pemeriksaan fisik dan pemeriksaan penunjang yang spesifik adalah penting untuk mencegah morbiditas dan mortalitas yang signifikan. Manajemen yang efektif dari empiema necessitans melibatkan perawatan yang cepat dan akurat, seperti intervensi bedah dan eskalasi antibiotik.


Kata Kunci


Empiema Necessitans, Tuberkulosis, Dekortikasi Torakotomi

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Referensi


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DOI: https://doi.org/10.33024/jikk.v12i7.20068

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