lapsus demam dengue

7/23/2019 LAPSUS Demam Dengue

1/35

DEMAM DENGUE

LAPORAN KASUS

Galuh Dharanindya Ica Manohara

112011101087

P!"i!"in# $ dr% Su#n# &%R%' S(% PD

SM) In*rna RSD dr% So"andi +!"r

)a,ul*a- Kdo,*ran Uni.r-i*a- +!"r

201/


2/35

Idn*i*a- Pa-in

Na!a $ Ny% AS+ni- ,la!in$ Pr!(uanU!ur $ 7 *ahun

S*a*u-$ Mni,ahA#a!a $ I-la!Ala!a* $ +l% P& Sudir!an 11

Pa*ran#' +!"rP,r3aan $ I"u Ru!ah an##aan##al MRS $ / +uli 201/an##al (!ri,-aan $ 4 +uli 201/


3/35

Ana!n-i-Kluhan u*a!a$ l!a-' (u-in#Ri5aya* Pnya,i* S,aran#$ Pa-in !n#luh

d!a! nai, *urun -3a, / hari yan# lalu% Pa-in!n#luh,an "adan *ra-a l!a- dan -a,i* -!ua'(u-in# 6' nyri (ru* 69' &A& 6 ,on-i-*n-i

nor!al 1 ,ali -hari "r5arna ,unin# ,co,la*an dan&AK 6 *ida, ada nyri -aa* &AK% S"lu!nya' (adahari ,9 d!a! (a-in !!ri,-a,an diri , do,*rdan !nda(a* o"a* -hin##a (a-in !ra-a l"ih"ai,' na!un (ada hari ,9/ (a-in !n#luh d!a!

la#i dn#an -uhu *u"uh nai, *urun di-r*ai !ual9!ual na!un *ida, !un*ah% K!udian (a-in c, la"dan !nda(a*,an *ro!"o-i* yan# !nurun -hin##a(a-in da*an# , RSD Dr% So"andi +!"r


4/35

Ana!n-i-

Ri5aya* Pnya,i* Dahulu $ :69' DM69'A-!a69

Ri5aya* Pnya,i* Kluar#a $:69' DM69'A-!a69

Ri5aya* Pn#o"a*an $Parac*a!ol'

a!o,-i-ilin


5/35

Ana!n-i-

Sistem Serebrospinal $ Pnurunan ,-adaran 69'D!a! 6' K3an# 69' (u-in#6%

Sistem Kardiovaskuler $ Pal(i*a-i 69' :i(r*n-i 69'

Nyri dada 69%

Sistem Pernafasan $ E(i-*a,-i- 69 Dy-(nau 69'&a*u, 69' Pil, 69' Prna;a-an cu(in# hidun# 69' R*ra,-idindin# dada 69' dan *ida, ada ,*r*in##alan #ra,%

Sistem Gastrointestinal$ Na;-u !a,an !nurun' Mual6' Mun*ah 69' &A& nor!al *ida, *rda(a* daraha*au(un lndir%

/


6/35

Ana!n-i-Sistem Urogenital $ &AK lancar dan *ida, nyri'

-r*a "r5arna ,unin# 3rnih%

Sistem Muskuloskeletal$ Nyri o*o* 6' ida,

ar*ro


7/35

P!ri,-aan )i-i,

KU $ l!ahK- $ co!(o-!n*i-

D $ 10070 !!:#:R $ 8=> !ni*RR $ 20> !ni*

a> $ 4'8 ?@KL $ aicd$ 9 9 9 9

hora>@or$I@ *rliha*I@ *ra"aRdu(S1 S2 *un##al

# ! B 9 9 9

hora>Pul!o$Si!*ri- R*ra,-i 9 9Sonor)R N NC- 'h 9 9 'Rh 9 9

A"do!n$@!"un#&U 6

i!(aniSo(l

E>*r!i*a- $A,ral han#a*

ida, *rda(a*od!a


8/35

P!ri,-aanLa"ora*oriu!/ +uli 201/

8

+ni- P!ri,-aan :a-ilP!ri,-aan

Nor!al Sa*uan

:EMAOLOGI LENGKAP6DL:!o#lo"in 1'4 12'0914'0 #rdL

La3u Enda( Darah =/70 092/ !!3a!Lu,o-i* '0 ='/911 10L:i*un# +ni- 9941/ Eo"a--*a"-#li!

!ono09=0919//=9422/9294

:!a*o,ri* '= 49=4 Fro!"o-i* 41 1/09=/0 10LGULA DARA:

Glu,o-a S5a,*u 10 -*i, 200 !#dLSEROLOGI9IMUNOLOGI

Dn#u &loodDn#u &lood I#M N#a*i( N#a*i(


9/35

P!ri,-aanLa"ora*oriu!4 +uli 201/


Nor!al Sa*uan

:EMAOLOGI LENGKAP6DL

:!o#lo"in 12'4 12'0914'0 #rdLLu,o-i* '1 ='/911 10L:!a*o,ri* 4'4 49=4 F

ro!"o-i* /= 1/09=/0 10L


10/35

P!ri,-aanLa"ora*oriu!7 +uli 201/

10


Nor!al Sa*uan

:EMAOLOGI LENGKAP6DL

:!o#lo"in 1'4 12'0914'0 #rdLLa3u Enda( Darah Sa!(l*ida, cu,u(u di(ri,-a

092/ !!3a!

Lu,o-i* /'8 ='/911 10L:i*un# +ni- 9994/2 Eo"a--*a"-#li!

!ono09=0919//=9422/9294

:!a*o,ri* '1 49=4 Fro!"o-i* 4= 1/09=/0 10L


11/35

Dia#no-i-

D!a! dn#u

11


12/35

ra(i

Plannin# ra(iIn;% ;u*roli* 1= *(!In3% Rani*idin 2> 1In3% @"ac*a! 2>1In3% M*il(rdni-olon 2> 12/ !#Po P-idii >1Po Sucral;a* > @I


13/35

Plannin# Edu,a-i$I-*iraha* cu,u(Mn3la-,an *n*an# (nya,i*'

(!ri,-aan yan# (rludila,u,an dan *inda,an !di-,(ada (a-in -r*a ,luar#a%

Mn3la-,an ,!un#,inan,o!(li,a-i dan (ro#no-i- ,(ada(a-in dan ,luar#a


14/35

Pro#no-i-

Du"ia ad "ona!


15/35

)ollo5 U(


16/35

P!"aha-an

14

Textbook Kondisi Pasien

D!a! Mual !un*ah Nyri ,(ala

Nyri r*roor"i*al Nyri o*o* Rua! ,uli* Mani;-*a-i (rdarahan Lu,o(ni ro!"o-i*o(ni Pnin#,a*an :c* 6/F910F ida, ada (r!"-an (la-!a

666

696696966669


17/35

P!"aha-an

Textbook PasienP!ri,-aan Pnun3an#$

Darah ln#,a( 6

U3i -rolo#i I#G dan I#M 6


18/35

P!"aha-an

18

Textbook Kondisi Pasien

Penatalaksanaan

Medikamentosa (dapat diberikan antipiretik)

Terapi suportif

Penatalaksanaan

In;% )u*roli* 1= *(!In3% Rani*idin 2> 1

In3% @"ac*a! 2>1In3% M*il(rdni-olon 2> 12/!#Po P-idii >1Po Sucral;a* > @IBedrest


19/35

DEMAM DENGUE


20/35

Pndahuluan

In;,-i .iru- dn#u "anya,di*!u,an di darah *ro(i- dan-u"9*ro(i-%

:O9SEARO !la(or,an "ah5a*ahun 200 *rda(a* 1/4%0/2,a-u- dn#u dn#an 14

3u!lah ,a-u- ,!a*ian diIndon-ia dan case fatality rate0'7F%

Di*ular,an olh #i#i*an nya!u,


21/35

D


22/35

E(id!iolo#i

Sumber : Ditjen PP P! Depkes "I# $%%&


23/35

E*iolo#i

In;,-i .iru- Dn#u di-"a",anolh .iru- dn#u' #nu-)la.i.iru-' ;a!ili )la.i.irida%

Ada = -ro*i( $ DEN1' DEN2'

DEN' DEN= .,*or nya!u,Aedes aegypti, Aedes albopictus.


24/35

C,*or

C,*or u*a!a (ny"aran d!a! dn#u diIndon-ia adalah nya!u, Ad- a#y(*i% Pnularan(nya,i* d!a! dn#u !laui #i#i*an nya!u,Ad- a#y(*i% Para ahli *a,-ono!i !n##olon#,an

nya!u, *r-"u* , dala!$ Phylu!$ An*rho(od- @la--$ :>a(oda

Ordo$ Di(*ra

Su"ordo$ N!a*oda

)a!ilia$ @ulicida Gnu-$ Ad-

S(ci-$ Ad- a#y(*i


25/35

Pa*o#n-i-


26/35

S(,*ru! ,lini- in;,-i dn#u


27/35

Pr3alanan (nya,i* in;,-idn#u

rdiri a*a- ;a- $)a- ;"ri- .ir!ia !ny"a",an d!a!

*in##i)a- ,ri*i-(r!"-an (la-!a$ on-*

!ndada, adanya (r!"-an (la-!adn#an dra3a* "r.aria-i (ada ;u-i (luradan a-i*-%)a-

rco.ry(ny!"uhancon.al-cnc(r!"-an (la-!a !ndada, "rhn*idi-r*ai dn#an ra"-or(-i cairan dan,-*ra.a-a-i (la-!a%


28/35


29/35

Ga!"aran Klini-

a. Undierentiated ;.r 6-indro!in;,-i .iru-

d!a! *ida, da(a* di"da,an

dn#an (ny"a" .iru- lain di-r*ai ,!rahan "ru(a

!a,ulo(a(ular' *i!"ul -aa* d!a!

rda G3ala dari -aluran (rna(a-an dan

-aluran crna -rin# di3u!(ai%


30/35

@on*%%

"% D!a! dn#u 6DDAna!n-i-$ d!a! !ndada, *in##i' di-r*ai nyri ,(ala'

nyri o*o* H -ndi*ulan#' nyri r*ro9or"i*al'photophobia,nyri (ada (un##un#' facial ushed, l-u' *ida, !au !a,an',on-*i(a-i' nyri (ru*' nyri *n##oro,

P!ri,-aan


31/35

@on*

@on.al-cn* ra-h' "ru(a (*,i!n#lilin#i darah yan# (uca* (ada,uli* yan# nor!al' di-r*ai ra-a #a*al

Mani;-*a-i (rdarahan$U3i "ndin# (o-i*i; dana*au (*,iMi!i-an h"a*' !n-*rua-i yan# l"ih

"anya,' (rdarahan -alurancrna63aran# *r3adi' da(a* *r3adi(ada DD dn#an *ro!"o-i*o(nia


32/35

DD'D(D G")D*

T)+D) D)+ G*,)!) !)(-")T-"IUM

D!a!Dn#u

D!a! di-r*ai !ini!al 2#3ala Nyri ,(ala

Nyri r*ro9or"i*al Nyri o*o* Nyri -ndi*ulan# Rua! ,uli* !a,ulo(a(ular Mani;-*a-i (rdarahan ida, ada *anda

(r!"-an (la-!a

Lu,o(nia 63u!lah lu,o-i* =000 -l!!

ro!"o-i*o(nia 63u!lah

*ro!"o-i* 100%000-l!! Pnin#,a*an h!a*o,ri*

6/F910F ida, ada "u,*i

(r!"-an (la-!a

D&D I D!a! dan !ani;-*a-i(rdarahan 6u3i "ndin#(o-i*i; dan *anda (r!"-an(la-!a

ro!"o-i*o(nia 6100%000-l!! ' (nin#,a*anh!a*o,ri* 20F

D&D II S(r*i dra3a* I di*a!"ahdn#an (rdarahan -(on*an


D&D6DSS

III S(r*i dra3a* I dan IIdi*a!"ah ,#a#alan -ir,ula-i6nadi l!ah' *,anan nadi 20!!:#' hi(o*n-i' #li-ah'diur-i- !nurun


D&D

6DSS

IC Syo, h"a* dn#an *,anandarah dan nadi yan# *ida,*rd*,-i



33/35

a*ala,-ana

Mdi,a!n*o-a $ an*i(ir*i, da(a*di"ri,an

Su(or*i;$

@airan$ cairan (r oral cairanin*ra.na ru!a*an (r hari /Fd


34/35

Indi,a-i (ulan#

&"a- d!a! !ini!al 2= 3a!*an(a an*i(ir*i,Na;-u !a,an *lah ,!"ali

Pr"ai,an ,lini- 6d!a! 69' di-*r-(rna;a-an 69' dan nadi *ra*urDiur-i- "ai,

Mini!al 29 hari -*lah -!"uhdari -yo, 6(ada DSSro!"o-i* /0%000!


35/35

T*"IM) K)SI.

lapsus demam dengue

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