Clinical Pathology Specialization Program (Clinical Pathology) - Airlangga University: Surabaya, ID
RESEARCH, TEACHING, or OTHER INTERESTS
Medicine, Immunology and Microbiology, Endocrinology, Diabetes and Metabolism, Hematology
4
Scopus Publications
3
Scholar Citations
1
Scholar h-index
Scopus Publications
Periorbital necrotizing fasciitis and Pseudomonas aeruginosa bacteremia complicating presumed herpes zoster ophthalmicus in advanced HIV: a case report Agus Adhari, Ni Made Mertaniasih, Siti Rochmanah Oktaviani Sulikah, Priyo Budi Purwono, Suhendra Mandala Ernas Romanian Journal of Infectious Diseases, 2026 A 31-year-old man with advanced HIV presented with bilateral periorbital swelling and a rapidly enlarging dark lesion over the nasal bridge. He had been diagnosed with HIV one month earlier, with a CD4 count of 11 cells/µL. Within days, progressive eyelid edema and central facial necrosis developed. A Tzanck smear was consistent with a clinical diagnosis of presumed herpes zoster ophthalmicus (HZO), while both blood and pus cultures grew Pseudomonas aeruginosa, confirming bacteremia with associated soft tissue involvement. A combination of viral reactivation and secondary bacterial infection may have contributed to the development of periorbital necrotizing fasciitis with orbital involvement. Targeted intravenous antiviral therapy and culture-guided antipseudomonal therapy stabilized the systemic infection, although visual function in the affected eye was not preserved. Reports describing a similar combination of presumed HZO-associated facial necrotizing fasciitis and Pseudomonas aeruginosa bacteremia in advanced HIV remain limited. This case underscores the importance of early microbiological confirmation and aggressive multidisciplinary management in severely immunocompromised patients presenting with rapidly progressive facial necrosis.
Subclinical hyperthyroidism in choriocarcinoma: a rare case with ovarian metastasis occurring eight years after molar pregnancy Syaifuddin Zuhri, Muhammad Noviandhy Geloed Asmara, Betty Agustina Tambunan, Andri Purbianto, Birama Robby Indraprasta, Suhendra Mandala Ernas Romanian Medical Journal, 2026 Background. Choriocarcinoma is the most aggressive form of gestational trophoblastic neoplasia (GTN), typically associated with high β-hCG levels and overt thyrotoxicosis. Subclinical hyperthyroidism in choriocarcinoma with ovarian metastasis and a prolonged latent interval after molar pregnancy is exceptionally rare. Case report. A 47-year-old woman presented with persistent vaginal bleeding, uterine enlargement, abdominal pain, and anemia eight years after molar pregnancy. Laboratory findings showed peak β-hCG of 217,273.51 mIU/mL, suppressed TSH (0.065 mIU/mL), and normal FT4 (1.15 ng/dL), consistent with subclinical hyperthyroidism. Imaging revealed a uterine mass with adnexal involvement. Histopathology following hysterectomy confirmed FIGO stage II choriocarcinoma with ovarian metastasis. Postoperatively, β-hCG declined to 1,851 mIU/mL and TSH normalized to 3.845 mIU/mL. Conclusion. This case highlights the heterogeneity of GTN, demonstrating subclinical hyperthyroidism despite marked β-hCG elevation and rare ovarian metastasis occurring eight years after molar pregnancy, emphasizing the need for long-term surveillance and careful endocrine evaluation.
Fourier transform infra-red role in diagnosis welder’s lung disease: a case report Andri Purbianto, Suhendra Mandala Ernas, Muhammad Robiul Fuadi, Herley Windo Setiawan Romanian Medical Journal, 2025 Background. Pneumosiderosis, or welder’s lung, is a rare occupational lung disease caused by chronic inhalation of iron dust. Clinical and imaging findings often overlap with other interstitial lung diseases (ILDs), making diagnosis challenging. While the gold standard is histopathological identification of iron-laden macrophages from lung tissue or bronchoalveolar lavage (BAL) fluid, this is not always feasible in resource-limited settings. Fourier transform infrared (FTIR) spectroscopy is a reagent-free, non-destructive technique that can serve as an adjunct to detect iron oxide deposits when histopathology is unavailable. Case. A 43-year-old man, a container welder with over 20 years of welding fume exposure, presented with progressive dyspnea and productive cough. Chest imaging revealed features suggestive of ILD. Laboratory tests showed elevated ferritin and positive antinuclear antibody (ANA) and anti-double-stranded DNA (anti-dsDNA) titers without systemic autoimmune manifestations. FTIR spectroscopy performed on the BAL sample detected Fe–O bond peaks consistent with iron oxide particles. Differential diagnoses, including hypersensitivity pneumonitis, silicosis, asbestosis, and post–COVID-19 sequelae, were considered and excluded based on clinical, radiological, and laboratory findings. The patient was treated with inhaled bronchodilators and corticosteroids, advised to stop welding exposure, and referred for pulmonary rehabilitation. Conclusion. This case demonstrates the potential role of FTIR spectroscopy as a rapid, non-invasive adjunctive tool for diagnosing pneumosiderosis when histopathology is not available. It also emphasizes the importance of integrating advanced spectroscopic methods into the diagnostic work-up of occupational lung diseases in resource-limited settings.
Hypoplastic marrow as a progression from Felty syndrome: A rare case report , Suhendra Mandala Ernas, , Arifoel Hajat, , , Paulus Budiono Notopuro, , , Antonius Johanes, and Romanian Journal of Rheumatology, 2025 Felty syndrome is a rare extra-articular manifestation of seropositive rheumatoid arthritis (RA), with a prevalence of approximately 1–3% among patients with RA. This report discusses the case of a 72-year-old female without splenomegaly. The patient had a three-year history of RA and had been receiving treatment with leflunomide and etanercept. On physical examination, there was tenderness and swelling in 10 joints. Laboratory tests revealed a leukocyte count of 3.52 × 10³/μL and a neutrophil count of 0.37 × 10³/μL. The ESR was 53 mm/hour and the CRP level was 57.2 mg/L. Rheumatoid factor test was positive. The DAS28-ESR score was calculated at 6.14. Bone marrow aspiration showed myeloid hyperplasia with increased granulopoiesis and a relative excess of immature forms, alongside hypoplastic marrow in other sites. The presence of cytopenia in patients with RA requires consideration of bone marrow examination to differentiate between drug-related cytopenia and complications of Felty syndrome.
RECENT SCHOLAR PUBLICATIONS
Subclinical hyperthyroidism in choriocarcinoma: a rare case with ovarian metastasis occurring eight years after molar pregnancy S Zuhri, MNG Asmara, BA Tambunan, A Purbianto, BR Indraprasta, ... Romanian Medical Journal 73 (1), 117-121 , 2026 2026
Periorbital necrotizing fasciitis and Pseudomonas aeruginosa bacteremia complicating presumed herpes zoster ophthalmicus in advanced HIV: a case report A Adhari, NM Mertaniasih, SRO Sulikah, PB Purwono, SM Ernas Romanian Journal of Infectious Diseases 29 (1), 36-41 , 2026 2026
Fourier transform infra-red role in diagnosis welder’s lung disease: a case report A Purbianto, SM Ernas, MR Fuadi, HW Setiawan Romanian Medical Journal 72 (No. 4, 2025), 558-566 , 2025 2025
Diabetic foot ulcer leading to septic shock: A rare case of multidrug-resistant infection in an uncontrolled diabetic patient SM Ernas, FA Aulia Microbes and Infectious Diseases , 2025 2025
Hypoplastic marrow as a progression from Felty syndrome: A rare case report SM Ernas, A Hajat, PB Notopuro, A Johanes 2025
Diabetes Mellitus Tipe 2 RY Maruf, S Ikom, S PD, N Wahyuni, ES Mastari, SM Ernas Penerbit Adab , 2025 2025
Perkembangan Pengobatan Berbahan Herbal Di Indonesia JS Pramono, HN Surura, ES Mastari, SM Ernas Penerbit Adab , 2025 2025 Citations: 3
Aspek Klinis Dan Laboratorium Pada Mixed Phenotype Acute Leukemia (MPAL) Dan Sindrom Hemofagositik Limfohistiositosis (HLH) YN Indrasari, SM Ernas, ALC Putri 2025
MOST CITED SCHOLAR PUBLICATIONS
Perkembangan Pengobatan Berbahan Herbal Di Indonesia JS Pramono, HN Surura, ES Mastari, SM Ernas Penerbit Adab , 2025 2025 Citations: 3
Subclinical hyperthyroidism in choriocarcinoma: a rare case with ovarian metastasis occurring eight years after molar pregnancy S Zuhri, MNG Asmara, BA Tambunan, A Purbianto, BR Indraprasta, ... Romanian Medical Journal 73 (1), 117-121 , 2026 2026
Periorbital necrotizing fasciitis and Pseudomonas aeruginosa bacteremia complicating presumed herpes zoster ophthalmicus in advanced HIV: a case report A Adhari, NM Mertaniasih, SRO Sulikah, PB Purwono, SM Ernas Romanian Journal of Infectious Diseases 29 (1), 36-41 , 2026 2026
Fourier transform infra-red role in diagnosis welder’s lung disease: a case report A Purbianto, SM Ernas, MR Fuadi, HW Setiawan Romanian Medical Journal 72 (No. 4, 2025), 558-566 , 2025 2025
Diabetic foot ulcer leading to septic shock: A rare case of multidrug-resistant infection in an uncontrolled diabetic patient SM Ernas, FA Aulia Microbes and Infectious Diseases , 2025 2025
Hypoplastic marrow as a progression from Felty syndrome: A rare case report SM Ernas, A Hajat, PB Notopuro, A Johanes 2025
Diabetes Mellitus Tipe 2 RY Maruf, S Ikom, S PD, N Wahyuni, ES Mastari, SM Ernas Penerbit Adab , 2025 2025
Aspek Klinis Dan Laboratorium Pada Mixed Phenotype Acute Leukemia (MPAL) Dan Sindrom Hemofagositik Limfohistiositosis (HLH) YN Indrasari, SM Ernas, ALC Putri 2025
