Background: Fournier gangrene is a disease with characteristic of rapidly progressive necrotizing fasciitis in the perianal and genitourinary area. Case: Usually it affects men, but we hereby present Fournier gangrene in an obese, diabetic, middle-aged woman. Her chief complaint was discomfort, swelling and foul odor coming from her genital area. Thus, she was diagnosed with Fournier gangrene and underwent emergency surgical debridement with local anaesthesia. After removing all necrotic tissues, overlying pus and debris, wounds were left open until granulation were seen and optimal condition of the tissue and planned for reconstructive surgery and additional debridement if needed. Local wound dressings were done with silver dressings and washed with 0.1% Polyaminopropyl biguanide solution. Patient received oral antibiotics daily for five days and visit surgery polyclinic twice a week for wound toilet and observation of wound condition. Conclusion: Early diagnosis, administration of broad-spectrum antibiotics and emergency debridement is important factors to successful outcome of Fournier gangrene.

The incidence of pneumothorax is 10% of all COVID-19 patients and increases in patients who develop acute respiratory distress syndrome (ARDS) with mechanical ventilation, responsible for 24% of the population. As many as 60.7% of patients who have complications of pneumothorax or pneumomediastinum lead to mortality. This study was established to determine the potential of early tracheostomy in preventing the occurrence of pneumothorax and pneumomediastinum in COVID-19 and reducing mortality. This research was conducted as a descriptive study by case series of three COVID-19 patients in Jakarta, Indonesia in the span of 2021-2022. Tracheostomy performed within 10 days, did not develop a pneumothorax. Although, the patient did not have any comorbidities, age below 70 years, and coagulopathy problem, there was still a risk of recurrent pneumothorax post COVID-19 after tracheostomy. However, a tracheostomy is a procedure that poses an aerosol risk, so there is concern about the transmission of COVID-19 to medical personnel who perform it. Early tracheostomy has the potential to accelerate the resolution of COVID-19 disease in patients and has a positive impact on lung vitality. It is aimed to prevent hypoxic conditions and optimize the lung recruitment process. In addition, they did not experience complications from COVID-19 in the form of an air leak syndrome such as a pneumothorax or pneumomediastinum.

Aim: Objective of the study is to find out the demographic and clinical profile of tuberculous mastitis (TM) patients. Methods: The study was carried out for a period of one year from August 2017 to August 2018 at Tebet General Hospital. Histopathologically diagnosed cases of TM were retrospectively studied. Results: All eight patients diagnosed as suffering from TM were females with the mean age of 37.25 years. Of these, two patients were lactating, six others were not, and 75% were multiparous. Unilateral involvement was observed in all cases. The right breast was affected in 62.5% and left breast in 37.5% cases. Patients presented with a solitary lump on one breast (87.5%), swelling of the breast (37.5%), and breast pain (100%). In the present study, two of the patients had previous positive tuberculosis (TB) contact and more than half found to be below an average economic level. All the patients were negative on the HIV test; also, there was no focus of TB elsewhere in the body. Conclusion: Tuberculosis should be considered as one possible cause of either mastitis or breast abscess. Histopathology examination played an important role in the diagnosis of TM. Standardized sequence for the diagnosis of TM is needed to increase awareness of the disease.

Background: Benign breast disease have been broadly classified into non-proliferative lesions, proliferative lesions without atypia and hyperplasia with atypia. Proliferative disease, such as usual ductal hyperplasia, is associated with a 1.5 to 2 fold increased risk of developing invasive carcinoma. We reported a case of usual ductal hyperplasia in a young male. Case: A 22-year-old male complained of discomfort and enlargement of unilateral breast. Physical examination at that time revealed a palpable mass in the lateral upper quadrant of the patient’s left breast, three centimeters from nipple areola complex. The examination of axilla didn’t reveal any lymph node enlargement on both sides. His vital signs were normal without any abnormalities found on examination. Ultrasonography examination demonstrated fibroglandular tissue in the left breast with the volume of 11.13 cm3, consist of 4.8 cm length, 2.9 cm width and 0.8 cm depth. Excisional tumor biopsy was done on his left breast. Usual duct cell hyperplasia was present in microscopic examination with chronic inflammatory cells spreading around the fibrotic stromal cell. Physical examination, radiologic examination, and biopsy were all performed in this patient. Although the accuracy of the triple test is high, benign concordant results do not obviate further surveillance of a palpable mass. We advised our patient to routinely follow-up his condition every 6 months for 1 to 2 years, especially if there any changes found on his breasts. Conclusion: Any guidelines and further studies regarding patient’s follow-up examination after biopsy for male breasts tumor are needed in order of better understanding about this disease.