Download - Laporan kasus toxoplasma
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TOXOPLASMA
Pembimbing: dr. Charles Hutasoit,Sp. A
dr.Ajuar Ari, Sp.A
Oleh:
!ebr" Loudr"an
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To#oplasmosis
• $ntrauterine ine%tion intra%ellularparasite Toxoplasma gondii
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$nsiden%e
• &'&( ) li*e births
• +(('+((( %ongenital abnormalit" )
"ear• Serolog" sur*e" (- SA/ 0('1(-
2urope
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2pidemiolog"
• 01- Central 2uropean
• 0&345- Latin'Ameri%an
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0+344- 6est Ari%an• +37-south8est Asia, China, and
9orea
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Patoph"siolog"
Oocyst%ats stool ;4'&+
d"s<
sporulation ;5+'51 d"s<
be%omeine%ti*e 3intermediate host%onsumingra8 meat or %ontaminatedpenetrationto gastro intestinal b"
sporozoit%ir%ulates in blood stream asta%h"=oit
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>is? !a%tors
• 2ating ) %onta%t 8ith ra8)under%oo?ed meat
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Cleaning the %at litter bo#• 2ating un8ashed *egetables)
ruitse#posure to soil
•
Tra*el outside:S, 2urope, Canada,et%
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Clini%al Maniestation
Obstructive hydrocephalusChorioretinitisDifuse intracranial calsication
!e*er Hepatosplenomegl" L"phadenopath" @omit H"pothrmia
H"perbilirubinemia Opti% atroph" Mi%rophthalmia >ash Pneumonia
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iagnose
Laboratory
Maternalserologi%
Be8born%lini%al suspi%ion serologi%
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Serologi%
Maternal:
• $gDpea? %onsentration &'5monthsremains ;<
• $gM;< &'5 8ee?spersists months or"ears
•
$gM E $gD ;'<
hasnt been e#posed
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Serologi% ;5<
Perinatal:
• iagnosis amnioti% Fuid PC>
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Cordo%enthesishigh ris? etal injur"• $gM E $gA antibod" %ross pla%enta
serodiagnosis %ongenital ine%tion
li*e ne8born
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>adiolog" studies
• Cranial ultrasonogrm or CT s%an o head
diGuse intra%ranial %al%i%ation
• Long'bone lmsmetaph"seal lu%en%" andirregularit" o %al%i%ation line at epiph"seal
plate 8ithout periosteal rea%tion
• Other stud" Ophthalmologi% e#am %hara%teristi%all" sho8n %horioretinitis.
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Treatment
• Suladia=ine 0( mg)?g, 5#)da"
• P"rimethamine 5 mg)?g)da", or 5 da"s
then, & mg)?g)da" or 5'I months
then, & mg)?g)da", #)8ee?
• !olini% a%id &( mg, #)8ee?
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Pre*ention
• Counseled about to#oplasma
• Coo?ing meat to sae temperature
• Peeling or thoroughl" 8ashing ruits and
*ege• Cleaning %oo?ing tools ater %onta%ted ra8
meat
• Bot eeding ra8 meat
• 9eep %at inside
• Se%ondar" pre*ention serologi%s%reening
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Prognosis
• Maternal during &'5 smt stillbirth;0-<
perinataldeath ;4-<
• Congenital to#o mortalit" ;&5-<
ris? in lie ;sei=ure, deaness,mental retard, *isual
impair, learning disorder<
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Than? Jou