Introduction: Amebiasis is defined as a parasitic infection with the protozoan Entamoeba histolytica. Amebiasis in pulmonary and pleural tissue is the second common location of extraintestinal amebias is after amoebic liver abscess. Pulmonary and pleural amebiasis happens in 2-3% of invasive amebiasis patients with mortality rate 5-16%. Case: We report a 22-year-old man with the chief complaint of dyspnea for one week. The patient also felt pain in the left chest, had productive cough and fever. He had a history of dysentery one month ago. BGA evaluation confirmed patient had respiratory failure type 1 with PCO2 35 and PO2 46.1. Thoracentesis was performed, the result was brown milk (anchovy paste) color and pleural fluid analysis revealed positive Entamoeba histolytica. Antimicrobial therapy and drainage were given with excellent response. Conclusion: Pulmonary and pleural amebiasis is an uncommon disease, usually occurring on the right side of the lung compared to the left side and rarely causing respiratory failure. Pulmonary amebiasis is a life-threatening, but treatable, condition. Antimicrobial therapy and drainage is an important strategy in pulmonary amebiasis management.
Hypertension is still the most prevalent non-communicable diseases in Indonesia. Renovascular hypertension is one type of secondary hypertension. It is commonly caused by the presence of renal artery stenosis (RAS). Whereas, atherosclerosis (ARAS) and fibromuscular disease (FMD) are the most common causes of RAS. Early diagnosis is necessary because it has the potential to be cured by eliminating stenosis of the renal artery. However, the signs and symptoms of renovascular hypertension are not specific. The supporting examination to diagnose RAS is also expensive. So, screening in the population at risk is needed. The examinations to prove the presence of RAS are arteriography, captopril renogram, renal ultrasonography, renal Doppler ultrasonography, magnetic resonance angiography (MRA), and computed angiographic tomography (CTA).
Until now, three therapeutic modalities can be selected in the management of renovascular hypertension; pharmacological therapy, surgical intervention, percutaneous intervention angioplasty with and without stenting. This narrative review summarizes the literature focused on the diagnosis and therapy of RAS.
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