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"The updated second edition of Cutaneous manifestations of infection in the immunocompromised host is an invaluable reference for physicians and ancillary medical professionals involved in the care of patients with impaired immune systems due to cancer, chemotherapy, systemic steroids and other immunosuppressive drugs, HIV/AIDS or organ transplantation. This volume will help you recognize skin lesions and diagnose their infectious cause. Textbook features include, over 350 color images demonstrating pathognomonic, atypical, rare and routine skin lesions. Tables for differential diagnosis of different skin lesions in the immunocompromised host. Complete coverage of infectious pathogens with the patterns of infection and the likely causes in different clinical settings (HIV/AIDS versus solid organ transplantation versus neutropenia post-chemotherapy versus bone marrow recovery post hematopoietic stem cell transplantation. New chapter discussing the role of viruses causing malignancies with cutaneous signs in the immunocompromised patient. "

"Cytomegalovirus (CMV) is a double-stranded DNA virus and a member of the Herpesviridae family. Cytomegalo- virus infection is one of the important causes of mortality and morbidity in immunocompromised patients. This is a case report of 72 year-old immunocompromised male patient with worsening cough needing an intubation despite previous adequate antibiotic administration. Further examination showed positive CMV infection. The patient showed improvement after administration of ganciclovir."

"Cytomegalovirus (CMV) merupakan suatu virus DNA rantai ganda, yang termasuk dalam famili Herpesviridae. Infeksi CMV merupakan salah satu penyebab penting mortalitas dan morbiditas pada pasien-pasien imunokompromais. Tulisan ini melaporkan kasus seorang pasien pria imunokompromais berusia 72 tahun dengan batuk yang semakin memburuk hingga perlu dilakukan intubasi, meskipun sebelumnya telah diberikan terapi antibiotik yang adekuat. Pemeriksaan lebih lanjut menunjukkan adanya positif infeksi CMV. Pasien menunjukkan adanya perbaikan setelah pemberian ganciclovir."

"A patient is said to be immuno-compromised (1C) if one or more of his or her natural and adaptive defense mechanisms are unable to function normally. Thus, immuno-compromised patients are easily susceptible to infection. Aim of study; to determine the immune response in immuno-compromised patients that makes them easily susceptible to infection. Method: the study was designed as a cross-sectional analytic observational study using multi-variant statistical tests. The samples were classified into the 1C and Non-iC groups, consisting of 14 people, 10 men, and 4 women, who were examined far the following immunologi-cal variables: IL-10, IFN-y, TNF-a, IL-I& IgG, C3, and C4. The results demonstrated a significant difference in the immune response of subjects from the 1C and NIC groups (p<0.05), with a significantly higher TNF-Ct, IL-10 and IgG levels, and a lower C3 level in the 1C group. Conclusion: during 1C conditions, there is a disorder in the natural as well as adaptive C3 natural immune system, making patients more susceptible to infection."

"Infeksi Strongyloides stercoralis adalah infeksi yang disebabkan oleh cacing nematoda usus pada manusia. Pada individu dengan imunokompromais, S.stercoralis menyebabkan morbiditas yang berat hingga kematian. Tujuan penelitian ini untuk mengetahui pengaruh infeksi S.stercoralis pada individu dengan imunokompromais. Penelitian ini menggunakan rancangan studi kasus kontrol dan dilaksanakan pada Maret - Juni 2013. Subyek merupakan pasien dengan kondisi imunokompromais dan imunokompeten berasal dari rumah sakit dan laboratorium di Jakarta. Bahan klinis (feses) yang berasal dari subyek dikirim ke laboratorium Departemen Parasitologi FKUI. Pengambilan sampel dilakukan dengan teknik consecutive sampling. Seluruh bahan klinis (feses) diperiksa dengan pemeriksaan langsung sediaan basah dan dilanjutkan dengan kultur Harada Mori. Kondisi imun pasien tersebut diketahui dengan menggunakan rekam medik/ surat pengantar yang ada. Total feses yang berhasil dikumpulkan sebanyak 170 feses; Laki-laki sebanyak 108 dan perempuan 62 orang. Kisaran umur pasien yaitu 2-80 tahun dengan rata-rata 33,41 ± 22,65. Pasien dengan imunokompromais sebanyak 31 (18,2%, 31/170) dan imunokompeten 139 (81,8%, 139/170). Sebanyak 18 (10,6%, 18/170) feses positif larva S.stercoralis; 11 (10,2%, 11/108) laki-laki dan 7 (11,3%, 7/62) perempuan. Dari subyek yang positif infeksi S.stercoralis diperoleh 6 (19,4%, 6/31) yang mempunyai status imunokompromais sedangkan pada imunokompeten 12 (8,6%, 12/139). Pada studi ini diperoleh OR 2,54 dengan P-value 0,082 (95% CI: 0,871 - 7.043). Hal ini menunjukkan bahwa status imunokompromais mempunyai hubungan yang positif terhadap infeksi S.stercoralis walaupun secara statistik tidak ada perbedaan signifikan. Dari hasil studi ini dapat menjadi masukan bagi klinisi untuk dasar pengambilan kebijakan untuk meningkatkan penatalaksanaan infeksi dengan keluhan diare terutama pada penderita imunokompromais.

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Strongyloides stercoralis infection is an infection caused by the human intestinal nematode worms. In immunocompromised individuals, S.stercoralis cause severe morbidity and fatality. The purpose of this study was to determine the effect of S.stercoralis infection among individual with immunocompromised state. A case control study was conducted between March-June 2013. Subjects were patients with immunocompromised and immunocompetent condition came from hospitals and laboratories in Jakarta . Who submitted their fecal specimen to parasitology FKUI. Sampling method was done by consecutive sampling technique. Direct examination with wet preparation was performed on the whole specimens followed by filter paper tube Harada Mori culture technique. The patient's immune status was identified from the medical record. There were 170 samples obtained from patients aged 2-80 years old (mean 33,1 ± 22,7); consisted of 108 men and 62 women; immunocompromised patients with as many as 31 (18.2 %, 31/170) and 139 immunocompetent (81.8 %, 139/170). A total of 18 (10.6 %, 18/170) faecal specimens was positive larval S.stercoralis which was proportionately similar between male and female patients. It was found that 6 (19,4%, 6/31) with immunocompromised and 12 immunocompetent (8,6%, 12/139). The odd ratio (OR) was 2,54 with P-value of 0,082 (95% CI: 0,871 to 7,043). Suggesting that immunocompromised state has a positive association to infection S.stercoralis although no statistically significant difference. this study recommends the clinician to increase awarness on S. stercoralis infection and management of infection with symptoms of diarrhea, especially in immunocompromised patients."

"Latar Belakang: Reseptor ACE2 tidak hanya terdapat pada paru-paru, tetapi juga pada saluran pencernaan yang memungkinkan terjadinya infeksi SARS-COV-2 pada enterosit, menimbulkan manifestasi klinis gastrointestinal, dan terdeteksinya RNA virus pada pemeriksaan swab anal. Studi lain di seluruh dunia menunjukkan hasil yang berbeda-beda serta belum didapatkan penelitian serupa di Indonesia. Tujuan: Penelitian ini bertujuan untuk mengetahui luaran klinis infeksi COVID- 19 pada pasien yang dilakukan swab anal, mendapatkan hubungan hasil pemeriksaan PCR SARS-CoV-2 swab anal dengan manifestasi klinis gastrointestinal dan derajat keparahan pada pasien COVID-19 di Indonesia. Metode: Merupakan cabang penelitian dari penelitian utama yang berjudul “Nilai RT-PCR Swab Anal untuk Diagnosis COVID-19 pada Orang Dewasa di Indonesia”. Penelitian ini merupakan studi analitik dengan desain potong lintang. Sampel penelitian merupakan pasien COVID-19 yang menjalani rawat inap di RSUPN dr. Cipto Mangunkusumo (RSCM), RS Mitra Keluarga Depok, RS Mitra Keluarga Kelapa Gading, dan RS Ciputra selama periode April 2020 sampai dengan Januari 2021. Dikumpulkan data demografi, manifestasi klinis, derajat keparahan, dan hasil swab anal PCR SARS-CoV-2.Hasil: 136 subjek penelitian dengan swab nasofaring positif dianalisis. 52 pasien (38,2%) dengan swab anal PCR SARS-CoV-2 positif dan 84 pasien (61,8%) dengan swab anal negatif. Manifestasi klinis saluran cerna tersering, yaitu: mual-muntah 69 pasien (50,7%), nafsu makan menurun sebanyak 62 pasien (45,6%), dan nyeri perut sebanyak 31 pasien (22,8). Terdapat 114 pasien (83,8%) tergolong dalam derajat ringan-sedang dan 22 pasien (16,2%) tergolong dalam berat-kritis. Terdapat hubungan yang bermakna secara proporsi statistik antara variabel hasil pemeriksaan PCR SARS-CoV-2 swab anal dengan manifestasi klinis gastrointestinal berupa keluhan diare atau mual-muntah (nilai p 0,031). Tidak terdapat hubungan yang bermakna secara proporsi statistik antara variabel hasil pemeriksaan PCR SARS-CoV-2 swab anal dengan derajat keparahan (nilai p 0,844).Simpulan: Terdapat hubungan antara hasil pemeriksaan PCR SARS-CoV-2 swab anal dengan manifestasi klinis gastrointestinal berupa keluhan diare atau mual- muntah dan tidak terdapat hubungan antara variabel hasil pemeriksaan PCR SARS- CoV-2 swab anal dengan derajat keparahan infeksi COVID-19.

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Background: ACE2 receptor is not only found in the lungs, but also in the digestive tract, which allows the occurrence of enterocyte infection, gastrointestinal clinical manifestations, and detection of viral RNA on anal swab PCR. Studies around the world show various results, yet there has been no similar study to be found in Indonesia.

Objective: This study aims to determine the clinical outcome of COVID-19 patients with gastrointestinal manifestations who were tested by anal swab, the relationship between anal swab PCR for SARS-CoV-2 test result with gastrointestinal clinical manifestations as well as the severity of COVID-19 patients in Indonesia.

Methods: This research is a branch of study titled. The Value of Anal Swab RT- PCR for COVID-19 Diagnosis in Adult Indonesian Patients. This is an analytical study with cross-sectional design. Samples were obtained from hospitalized COVID-19 patients at RSUPN dr. Cipto Mangunkusumo (RSCM), Mitra Keluarga Hospital Depok, Mitra Keluarga Kelapa Gading Hospital, and Ciputra Hospital from April 2020 to January 2021. Demographic data, clinical manifestations, severity, and SARS-CoV-2 PCR anal swab were collected.

Results: 136 subjects with positive nasopharyngeal swab were analyzed. Result showed that 52 patients (38.2%) had positive anal swabs PCR SARS-CoV-2 and 84 patients (61.8%) had negative anal swabs. Common gastrointestinal clinical manifestations were: nausea and vomiting in 69 patients (50.7%), anorexia in 62 patients (45.6%), and abdominal pain in 31 patients (22.8). There were 114 patients (83,8%) classified as mild-moderate and 22 patients (16,2%) as severe-critical. There was a statistically significant relationship between anal swab PCR for SARS- CoV-2 test result with gastrointestinal clinical manifestations (diarrhea or nausea- vomiting) (p value 0.031). There was no statistically significant relationship found between anal swab PCR for SARS-CoV-2 test result with the severity of COVID- 19 infection (p value 0.844).

Conclusions: There is a relationship between anal swab PCR SARS-CoV-2 test result with gastrointestinal clinical manifestations (diarrhea or nausea-vomiting) and there is no relationship between anal swab PCR SARS-CoV-2 test result with severity of COVID-19 infection."