Group 1

Member's name

1. Annisa Alfitri
2. Berita Naenggolan
3. Dewi Pulung Sari
4. Febrina Lintang Nurindah
5. Imelia Putri J
6. Restu Ramdani

Class : 2D

JOURNAL REVIEW

A. Title :
Maculopapular drug eruption in a patient with human immunodeficiency
viral (HIV) infection, wasting syndrome and pulmonary tuberculosis: A
case reports
B. Author's Name :
JKKI SCIENTIA EST BASIC VITAE
C. Publication Year :
2023
D. Volume and Pages :
The case report "Maculopapular drug eruption in a patient with human
immunodeficiency virus (HIV) infection, wasting syndrome and pulmonary
tuberculosis: A case report" by Oktavriana et al. was published in Volume 14, Issue 3
of the Journal Indonesian Medicine and Health (JKKI) (Page 1). The specific pages
where the article can be found are pages 357-364 (Page 8).
E. Data Source:
The data and information provided in the responses are sourced from the PDF file
titled "16. Oktavriana , et al. Maculopapular drug eruption in... JKKI 2023;14(3): 357-
364" (Page 4).
F. Problem:
 The case report highlights several key issues and challenges in the management of
patients with complex medical conditions, including:

1. Maculopapular Drug Eruption : The development of a maculopapular drug

eruption in a patient with HIV infection, wasting syndrome, and pulmonary
tuberculosis raises concerns about the potential adverse effects of medications,
especially in individuals with compromised immune systems.
2. Complications of HIV : Patients with HIV infection may experience various
complications, such as wasting syndrome, which can further complicate the
management of other conditions such as pulmonary tuberculosis.
3. Drug Interactions : Managing multiple medications for HIV, tuberculosis, and
the drug eruption requires careful consideration of potential drug interactions
and adverse effects, highlighting the importance of comprehensive medication
management
4. Systemic Symptoms : The case report underscores the challenge of
distinguishing between mild and severe systemic symptoms in patients with
complex medical histories, considering the need for close monitoring and
prompt intervention
5. Multidisciplinary Care : Providing holistic care for patients with HIV, wasting
syndrome, and tuberculosis necessitates a multidisciplinary approach
involving dermatologists, infectious disease specialists, and other healthcare
professionals to address the diverse needs of the patient.

Addressing these issues requires a comprehensive understanding of the interplay

between different medical conditions, medications, and immune responses in
individuals with overlapping health concerns

G. Research Purposes :
The primary objective of the research conducted by Oktavriana et al. was to present a
case report detailing a maculopapular drug eruption in a patient with human
immunodeficiency virus (HIV) infection, wasting syndrome, and pulmonary
tuberculosis. The study aimed to provide valuable insights into the challenges and
complexities associated with managing drug eruptions in individuals with multiple
comorbidities, particularly in the context of HIV infection and tuberculosis [T4].
 By documenting the clinical presentation, diagnosis, treatment, and outcomes of the
case, the researchers sought to enhance understanding among healthcare providers
regarding the unique considerations and potential complications that may arise when
treating patients with overlapping medical conditions. Additionally, the study aimed to
contribute to the existing literature on drug eruptions in HIV patients with wasting
syndrome and pulmonary tuberculosis, highlighting the importance of tailored and
multidisciplinary approaches to patient care in such complex scenarios.
H. Research Methods:
The research methodology employed in the study conducted by Oktavriana et al.
involved a case report approach to document and analyze a specific clinical case of a
maculopapular drug eruption in a patient with HIV infection, wasting syndrome, and
pulmonary tuberculosis [T4].
Key aspects of the research methodology include:
1. Case Description : The researchers provided a detailed description of the patient's
clinical presentation, including symptoms, medical history, diagnostic findings,
and treatment interventions
2. Diagnosis and Treatment : The study outlined the diagnostic process used to
identify the maculopapular drug eruption in the context of the patient's underlying
condition. It also described the treatment regimen administered to manage the
eruption
I. Research Results:
The results of the research conducted by Oktavriana et al. documented a case of
maculopapular drug eruption in a patient with HIV infection, wasting syndrome, and
pulmonary tuberculosis. The key findings and outcomes of the study included:

1. Clinical Presentation : The patient presented with symptoms of itchy skin rash on
the hands, body, and feet following a streptomycin injection, accompanied by
fever, weakness, dizziness, and chronic cough [T4]
2. Diagnosis and Treatment : The patient was diagnosed with a new case of
pulmonary tuberculosis and received first-line anti-tuberculosis drugs (ATD).
Treatment included methylprednisolone injection, paracetamol infusion,
omeprazole injection, oral cetirizine, and moisturizer. The ATD was discontinued,
and the patient also received antiretroviral therapy (ARV) for HIV infection [T2].
 3. Clinical Improvement : After four days of hospitalization and treatment, the
patient experienced improvement in clinical symptoms and skin lesions. The
patient was discharged from the hospital with outpatient follow-up [T2]
4. Implications : The case report highlighted the challenges of managing drug
eruptions in patients with complex medical conditions, highlighting the
importance of tailored treatment approaches and multidisciplinary care in such
scenarios [T4].

Overall, the study's results underscored the need for comprehensive evaluation and
management of drug eruptions in individuals with HIV infection, wasting syndrome,
and tuberculosis, aiming to improve patient outcomes and quality of care in similar
clinical settings
J. Excess :
The research conducted by Oktavriana et al. on a case of maculopapular drug eruption
in a patient with HIV infection, wasting syndrome, and pulmonary tuberculosis offers
several strengths and advantages:
1. Clinical Relevance : The study addresses a clinically significant issue by documenting
a rare case of drug eruption in a patient with multiple comorbidities, providing
valuable insights for healthcare providers managing similar complex cases
2. Comprehensive Approach : The research employs a multidisciplinary approach
involving dermatologists, infectious disease specialists, and other healthcare
professionals to ensure holistic care and treatment for the patient, reflecting a
comprehensive and patient- centered approach
3. Detailed Case Description : The study provides a detailed description of the patient's
clinical presentation, diagnostic process, treatment interventions, and outcomes,
enhancing understanding of the complexities involved in managing drug eruptions in
individuals with overlapping medical conditions
4. Treatment Outcomes : By documenting the patient's clinical improvement and
response to treatment, the study demonstrates the effectiveness of the therapeutic
interventions implemented, highlighting the importance of tailored and timely
management strategies
5. Contribution to Literature : The case report contributes to the existing literature on
drug eruptions in HIV patients with wasting syndrome and tuberculosis, adding to the
 body of knowledge and potentially guiding future research and clinical practice in
similar contexts.

Overall, the research study's strengths lie in its clinical relevance, comprehensive
approach, detailed case description, treatment outcomes, and contribution to the
scientific literature, making it a valuable resource for healthcare professionals
involved in the care of patients with complex medical conditions and drug eruptions .
K. Lack:
While the research conducted by Oktavriana et al. on a case of maculopapular drug
eruption in a patient with HIV infection, wasting syndrome, and pulmonary
tuberculosis has several strengths, there are also potential limitations to consider:
1. Single Case Study : The study is based on a single case report, which may limit the
generalizability of the findings to a broader population. The results and outcomes
observed in this specific case may not be representative of all patients with similar
comorbidities
2. Limited Sample Size : Due to the focus on a single patient case, the study may lack
statistical power and the ability to draw definitive conclusions about the management
of drug eruptions in patients with HIV, wasting syndrome, and tuberculosis
3. Bias and Confounding Factors : As with any case report, there is a risk of bias and
confounding factors that could influence the interpretation of results. The presence of
multiple comorbidities in the patient may introduce complexities that are challenging
to account for in a single case study
4. Lack of Comparative Analysis : The study does not include a comparative analysis
with other similar cases or treatment approaches, which could provide additional
insights into the effectiveness of different management strategies for drug eruptions in
patients with complex medical conditions
5. Limited Follow-up : The duration of follow-up in the study may be limited,
potentially impacting the assessment of long-term outcomes and the sustainability of
treatment effects beyond the immediate post-treatment period
6. Publication Bias : There is a possibility of publication bias, where only cases with
unique or significant features are reported, leading to an overrepresentation of rare or
severe cases in the literature.
Addressing these limitations through larger-scale studies, comparative analyses,
longer follow-up periods, and efforts to minimize bias can strengthen the validity and
generalizability of future research on drug eruptions in patients with HIV, wasting
syndrome, and tuberculosis.