dhf udah slese

8/18/2019 DHF udah slese

1/43

CASE REPORTDENGUE HEMORRHAGIC FEVER Tutor,

Dr. Leopold Sim!"u!t#, Sp.A

Pre$e!ted %&,Mrt' Hp$ri ()*+)-


2/43


3/43


4/43


5/43


6/43

Det'$ '=e totlled "nearly 100" 33ordi!5 toDr. Hrold M!del. A!& o!e o4 t'e 4our de!5ue=iru$e$ ((DEN+6, DEN+, DEN+?, or DEN+*-- i$tr!$mitted =i t'e %ite o4 t'e Aede$ e5&ptimo$@uito, 0'i3' li#e ll mo$@uito$ %reed$ i!puddle$ o4 $t5!!t 0ter.000.0'o.i!t


7/43


8/43

Ptop'&$iolo5&

T'e mo$t 3ommo! t'eorie$ i$ $e3o!dr&i!4e3tio! '&pot'e$i$ (t'eor& 'eterolo5ou$

$e3o!dr& i!4e3tio!-. T'ere re 4our di$ti!3t, %ut 3lo$el&

relted, =iru$e$ t't 3u$e de!5ue.Re3o=er& 4rom i!4e3tio! %& o!e pro=ide$

li4elo!5 immu!it& 5i!$t t't =iru$ %ut3o!4er$ o!l& prtil !d tr!$ie!tprote3tio! 5i!$t $u%$e@ue!t i!4e3tio!%& t'e ot'er t'ree =iru$e$.


9/43


10/43

PATHOPHSIOLOG

:e$ide$ 3ti=ted 3ompleme!t$ $&$temt't i$$ued !8lto;i! $u%$t!3e$,

t'ere re ot'er$ 43tor$ t't 0ill led toi!3re$ed 3pillr& perme%ilit& !d'emo$t$i$ di$order$, 0'i3' re B

6. pltelet 55re5tio!

. T'e dm5e e!dot'elil 3ell$ o4 %lood=e$$el$


11/43

PATHOPHSIOLOG

Pltelet 55re5tio! t'e !um%er o4pltelet$ de3re$ed, i4 t'e$e e=e!t$

3o!ti!ue, it 3! 3u$e plteletd&$4u!3tio! $ re$ult o4 t'e &ou!5pltelet$ 3ell mo%ili>tio! 4rom t'e%o!e mrro0.

T'e dm5e e!dot'elil 3ell$ o4 %lood=e$$el$ t't 0ill re$ult i! 3ti=ted t'e3lotti!5 43tor.


12/43

DIAGNOSIS


13/43


14/43


15/43


16/43

TREATMENT

6. Immedite Repl3eme!t o4 pl$mlo$$

Fluid$ u$ed 4or rpid =olume B› P'&$iolo5i3l $li!e

› Ri!5er$ l3tte or Ri!5er$ 3ette

› < 5lu3o$e $olutio! diluted 6 B or 6B 6 i!

p'&$iolo5i3l $li!e

› Pl$m, pl$m $u%$titute (e.5. de;tr!*)- or


17/43


18/43

000.$p3e!et0or#.3om


19/43

Criteri 4or di$3'r5i!5 i!ptie!t$

› A%$e!3e o4 4e=er

› Retur! o4 ppetite

›

Vi$i%le 3li!i3l impro=eme!t› Good uri!e output

› St%le 'emto3rit


20/43

Case Report DHF grade III


21/43

Ide!tit$ P$ie!B

Nm le!5#p BA!. FA

U$i B1 T'u!

e!i$elmi! BL#i+l#i

Almt B C0!5

A5m BI$lm

Su#u BI!do!e$i

Pe!didi#! BSe#ol' D$r


22/43

Ide!tit$ Or!5 Tu

Nm B T!. AS

Umur B *6 T'u!

Pe#e"!B r&0! Pe!didi#! B SMA

Nm I%u B N& M

Umur B ?< T'u!

Pe#er"! B I%u rum' t!55

Pe!didi#! B SMA


23/43

elu'! UtmB

› Demm

elu'! Tm%'!

› Mul d! mu!t'


24/43

Ri0&t pe!&#it$e#r!5 B

* 'ri SMRS p$ie! demm &!5 tim%ul $e3r ti%+ti% $etel' p$ie! pul!5 dri$e#ol'. Demmm %erl!5$u!5 teru$ me!eru$$ep!"!5 'ride!5! $u'u &!5 diu#ur?1C. Su'u tu%u' p$ie! turu! $e%e!tr $etel' mi!um o%t pe!uru! p!$ %eruppr$etmol !mu! #em%li me!"di demm. Selm $#it p$ie! '!& %eri$tir'tdirum' d! tid# mel#u#! #ti8t$ $eperti %i$!& $mpi pd 'ri #e ? demm.Mul d! mu!t', mimi$!, 5u$i %erdr', mu!t' dr', %er# dr' , !&eri otot$eluru' tu%u' di$!5#l.

6 'ri SMRS p$ie! tetp demm "u5 di$erti mul d! mu!t' 6; $etel' m#!. I$imu!t' $e%!&# 6? 5el$ @u, %erup m#!! &!5 dim#!, le!der tid# d,dr' tid# d.

6 "m SMRS demm $em#i! ti!55i de!5! $u'u &!5 diu#ur me!3pi *)C. Hl i!imem%ut t!te d! &' p$ie! mem%0 p$ie! %ero%t #e do#ter umum. Ole'

do#ter umum p$ie! di%eri o%t pe!uru! p!$d! o%t u!tu# mul. Seli! itu do#ter "u5 me!5!"ur#! u!tu# mel#u#! pemeri#$! dr' di l%ortorium.

"m SMRS p$ie! #em%li mu!t' 6; $e%!&# 6? 5el$ @u %eri$i m#!!&!5 dim#!, le!dir tid# d, dr' tid# d.

? "m SMRS etel' dil#u#! pemeri#$! dr' di l%ortorium, do#ter mem%3'$il d! me!&impul#! %'0 p$ie! me!derit demm %erdr' de!5ue. Do#terme!5!"ur#! 5r p$ie! dir0t $e'i!55 p$ie! diru"u# #e RSU UI.


25/43

Ri0&t Pe!&#it D'ulu

P$ie! %elum per!' me!derit $#it$eperti i!i $e%elum!&. P$ie!me!derit T: $t %erumur 6 t'u!d! tel' me!"l!i pe!5o%t!

$elm %ul! d! di#t#! $em%u'ole' do#ter

Ri0&t Pe!&#it elur5Di$!5#l


26/43

Ri0&t el'ir!

T!55l l'ir B ?6 A5u$tu$ ))6

A!# #e B ?

Tempt %er$li! B Rum' %er$li!

Pe!olo!5 per$li!!B :id!

Cr per$li!! B Prtu$ per=5i!m

U$i e'mil! B Cu#up %ul! (?2Mi!55u- :ert %d! l'ir B ?)))Grm

P!"!5 %d! l'ir B


27/43

DATA ANTROPOMETRI

› :ert %d! B ) 5

› Ti!55i %d! B 66< Cm

(:::: P


28/43


29/43

T%el imu!i$$i


30/43

Pemeri#$! "$m!i 6Mret )6), p#l. .))7I:

ed! umum B Tmp# $#it $ed!5(5er#! p$i4, lem', tid# d per!p$!3upi!5 'idu!5-

e$dr! B Compo$ me!ti$ (#omu!i#ti4,#o!t# mt (--

Te#!! dr' B 6))/) mmH5

Fre#ue!$i !di B 6));me!it (lem', #ut

!5#t, re5ulr-

Fre#ue!$i !p$ B ?) ; me!it (de#ut, re5ulr-

Su'u B ?1,C


31/43

Sttu$ 5e!erli$

epl B !ormo3ep'li,rm%ut 'itm di$tri%u$i mert,tid# mud' di3%ut.

MtB#o!"u!5ti= 'iperemi$, perdr'!

$u%#o!"u!5ti=(+-,$#ler tid# #u!i!5. Teli!5 B !ormoti, li!5 teli!5 lp!5lp!5,

$erume!++, 5e!d!5 teli!5 i!t#i!t#, ree# 3'&.

Hidu!5 B %e!tu# %i$, 3=um !$i lp!5,$e#ret++,

perdr'!++, 3o!3' eutro8, tid# 'iperemi$. Mulut B mu#o$ %i%ir #eri!5, perdr'! 5u$i (+-, lid'

tid# #otor, to!$il T6+T6 'iperemi$, 4ri!5$ 'iperemi$

Le'er B G: re5io!l tid# ter% mem%e$r.


32/43

T'or#$ B

I Bper5er#!

di!di!5 dd$imetri$

Pl B =o#l 4remitu$#!!K#iri

Per B $o!or#!!K#iri

Au$ B :ND =e$i#uler,R'++, 7' ++.

Cor B S6+S !orml,murmur (+-, 5llop(+-

A%dome! B

I B perut tmp#dtr

Au$B %i$i!5u$u$(-*;m!t

Pl B $upel, 'epr

ter% 6?+6?:l!#'rt,tepit"m,#o!$i$te!$i

#e!&l permu#!

rt, !&eri te#!(-. Lie! tid#

ter% mem%e$r

Per# B timp!i


33/43

E#$tremit$ B #rl di!5i!, capillary

refll , $i!o$i$(+-

ulit B pete#ie $po!t! (+-


34/43

PemeriksaanLaoratorium Rumplee leede (-

H$il l% (6+)?+)6),pu#ul 6.?1- B

› H% B 6*,? 5dl› Ht B **,2

› Leu#o$it B */))l

› Trom%o$itB

*2.)))l.

LEDB


35/43

Diagnosis ker!a

Demm :erdr' De!5ue der"t I

Diagnosis anding

Demm De!5ueDemm C'i#u!5u!&


36/43

"erapi ##$%% &I'

R0t i!p

Diet lu!#

IVFD RL


37/43

Ana(isa Kasus

Pd t!55l 6 Mret )6) $eor!5 !# l#i l#i %eru$i 1 t'u! :: ) 5, T: 66


38/43

p


39/43


40/43


41/43

Foto $i!r QB T'or; po$i$i po$tero!terior d! ri5't lterlde3u%%itu$


42/43

P)*'AHASAN

Dri pe!emu! pd !m!e$, pemeri#$! 8$i# d! l%ortorium

pd 'ri pertm p$ie! m$u# rum' $#it dpt didi5!o$ $e%5idemm %erdr' de!5ue der"t III #re! tel' meme!u'i #riteri7HO &itu B

Demm me!dd# ti!55i $mpi / 'ri

Heptome5li

L%ortori$ B

Trom%o$itope!i ( 6)).)))l -

Hemo#o!$e!tr$i ( #dr Ht ) dri !orml -

Pd p$ie! i!i me!u!"u##! #ed! &!5 dpt "tu' #edlm 4$e$&o# dri per"l!! pe!&#it!&, ter"di pd 4e%ri$ 'ri #elim,#re! t!d+t!d =itl p$ie! $em#i! me!uru! (te#.!di)mmH5, !di m$i' ter%, te# !di m$i' teru#ur-, terdpt'eptome5li, d!& e4u$i pleur, $ert !ili 'emto#rit me!i!5#t

) d! trom%o$it turu! di%0' 6)).)))l..


43/43

AGA ESEHATAN AH ANGAN IUTI EAU

dhf udah slese

Documents