presentasi laporan kasus dss

7/25/2019 Presentasi Laporan Kasus Dss

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OLEH :

PUTRI AYU KESUMA

PEMBIMBING :

DR. H. ASEP SYAIFUL KARIM, SP.PD

Dengue Shock Syndrome (DSS)

Laporan Kasus


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BAB ILAPORAN KASUS

I. IDENTIFIKASI

Nm ! Nn. "

Umur ! #$ %hun& ' un

*en+, kem+n ! Perem-un

Tg. Lh+r ! #/##/#

Am% ! K-. Sumur No. 0# RT1R2 341#4&Kender. Duren S5+%

No. R" ! 3#3#4#6#

Tg. D+r5% ! #7 *nur+ '3#$

Tg. Pemer+k,n ! #8/#/'3#$


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II. ANAMNESISD+kukn -d hr+ Sen+n& %ngg #8 *nur+ '3#$ -uku #0.33 2IB,ecr u%onmne,+, dn onmne,+, dengn orng %u -,+en.

Keluhan Utama:

Demm R!a"at #en"a$t %e$a&an':

P,+en d%ng ke I9D RSUD Budh+ A,+h dengn keuhn demm ,e:k 6hr+ S"RS& demm n+k %urun& mengg+g+ (;). Demm %urun ,een%rdengn o% -enurun -n, kemud+n n+k g+. B%uk (;)& mu (;)&mun%h (/)& nyer+ ke- (;)& -u,+ng (;)& nyer+ uu h%+ (;)& ,e,k (;)& n


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R!a"at #en"a$t %e$a&an' (lan)utan*

P,+en ,eeumny d+5 ero% ke dok%erumum d+ Pu,ke,m,& d+kukn %e, rumple leed

dn h,+ny -o,+%+ ! #6&7g1dL& >% 66&6?& %romo,+% 03 r+u1=L&kemud+n -,+en d+ru:uk ke RSUD Budh+ A,+h.


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R+5y% Penyk+% Sekrng


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R!a"at Pen"a$t Dahulu:P,+en -ernh mengm+ ,k+% DBD ,eeumny.R+5y% ,k+% mr+ d+,ngkR+5y% e-erg+n ke ur derh d+,ngk

R+5y% ,k+% %+


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Peme&$%aan F%$

KU ! Tm-k ,k+% ,edng

Ke,drn ! @om-o, men%+,

BB ! 63 kg

TB ! #$7 cm

B"I ! #6&$

S%%u, g++ ! g++ kurng

Tnd +% !

TD! 31$3mm>gN! #38 C1mn%

RR! '6 C1mn%

S! 08&33@


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Ke- ! Normoce-h+

Rmu%! uru, ,ukr d+ cu%

"% ! Kon:ung%+! Anem+, (/1/) Scer ! Ik%eru, (/1/)

Pu-+! I,okor& '&7 mm1 '&7 mm

Te+ng ! Normo%+& NT (/)& NT (/)

>+dung ! Perdrhn ! (/)

Secre% ! (/)

"uu% ! B++r! Ker+ng (;)

Ton,+! T#1 T#& >+-erem+, (/)

Fr+ng! >+-erem+, (/)

L+dh! Ko%or (/)

9+g+/ge+g+! @r+e, (/)9u,+! Perdrhn (/)

Leher ! K9B ! T+dk d -eme,rn

T+ro+d! T+dk d -eme,rn

Kku kuduk! (/)


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ThorC! In,-ek,+! S+me%r+, k+r+ knn

Ben%uk! Normoche,%

Se +g! S+me%r+, k+r+ knn& ke,n meer (/)

Pru ! P-,+! ok e-r! T+dk d -eme,rn

L+en! T+dk d -eme,rn

9+n:! dn

Perku,+ ! T+m-n+ (;)


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A% kem+n ! T+dk d ke+nn

Anu, dn rec%um ! T+dk d ke+nn

Ek,%rem+%, !

A%, !

Edem (/1/)

P%ek+e (;)

Akr d+ng+n (;)

B5h !

Edem (/1/)

P%ek+e (/)

Akr d+ng+n (;)


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Pemer+k,n -enun:ng Peme&$%aan La-&at&um

Tngg #71#1'3#$ (U9D)Jenis pemeriksaan Hasil Nilai normal

Leukosit 2,5 ribu/L 4,5-12,5

Eritrosit 4,6 juta/L 3,-5,2

Hb 14,5 !/"L 12,-16,

Ht 42 # 35-4$

%rombosit 1& ribu/L 154-36

'() &*, +L *-1**

'(H 31,3 p! 26-34

'(H( 34,4 !/"L 32-36

. 12,* # 14

0% &3 m/"l 2$

0% 4& m/"l 23

0 1*3 m!/"L 11*

Natrium Na 13$ mmol/L 135-155

7alium 7 3,6 mmol/L 3,6-5,5

7lori"a (l 1*$ mmol/L &-1*&


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Jenis pemeriksaan Hasil Nilai normal

Leukosit 2, ribu/L 4,5-12,5

Eritrosit 4,$ juta/L 3,-5,2

Hb 13,5 !/"L 12,-16,

Ht 3 # 35-4$

%rombosit 2 ribu/L 154-36

'() *,& +L *-1**

'(H 2,6 p! 26-34

'(H( 35,3 !/"L 32-36

. 11,6 # 14

% 14,5 "etik 12-1$

8%% 45,$ "etik 2*-4*

9ibrino!en 16& m!/"L 2**-4**

-"imer *,1 m!/L *,3

7alsium :on 1,*& mmol/L 1,13-1,32

pH $,4$ $,35-$,45

(2 25 mmH! 35-45

2 144 mmH! *-1**

;i


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Laktat "ara> 1,& mmol/L *,5-2,2

rotein total 4, !/"L 6,*-,*

8lbumin 2,$ !/"L 3,2-4,5

lobulin 2?1 !/"L 1,-3,5

ula "ara> (:% 114 m!/"L 11*

reum 15 m!/"L 11-3&

7reatinin *,5& m!/"L 1,*

Natrium Na 14* mmol/L 135-145

7alium 7 3,& mmol/L 3,6-5,5

7lori"a (l 112 mmol/L &-1*&

'a!nesium '! 2,14 m!/"L 1,6-2,6

( kuantitati+ 5 !/L 5

ro


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rinalisis @

.arna 7unin! 7unin!

7ejerni>an 8!ak keru> Jerni>

lukosa Ne!atiAe Ne!atiAe

;ilirubin Ne!atiAe Ne!atiAe

7eton Ne!atiAe Ne!atiAe

H 6,5 4,6-

;erat jenis 1?*15 1?**5-1?*3*

8lbumin urine 2B Ne!atiAe

robilino!en *,2 E??/"L *,1-1

Nitrit Ne!atiAe Ne!atiAe

ara> 1B Ne!atiAe

Esterase lekosit Ne!atiAe Ne!atiAe

0e"imen urine @

Lekosit 2-4 /L; 5

Eritrosit 2-4 /L; 2

Epitel ositi+ ositi+

0ilin"er Ne!atiAe Ne!atiAe

7ristal Ne!atiAe Ne!atiAe

;akteri Ne!atiAe Ne!atiAe

Jamur Ne!atiAe /L; Ne!atiAe


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Tngg #41#1'3#$ (I@U)


Leukosit 4,1 4,5-12,5

Eritrosit 5,1 3,-5,2

Hb 14,3 12,-16,

Ht 42 35-4$

%rombosit 3$ 154-36

'() 1,2 *-1**

'(H 2$,& 26-34

'(H( 34,4 32-36

. 11,$ 14

7alsium ion 1,25 1,13-1,32

pH $,44 $,35-$,45

(2 32 35-45

2 2** *-1**

;i


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lukosa "ara> jam *6?** & 11*

Natrium Na 142 135-155

7alium 7 3,& 3,6-5,5

7lori"a (l 112 &-1*&

8nti en!ue :! ositi+ Ne!atiAe

8nti en!ue :!' ositi+ Ne!atiAe

;erat jenis 1*25 1?**5-1?*3*


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Leukosit 3, 4,5-12,5

Eritrosit 5,1 3,-5,2

Hb 13,$ 12,-16,

Ht 41 35-4$

%rombosit $2 154-36

'() 1,& *-1**

'(H 2$,1 26-34

'(H( 33,1 32-36

. 11,$ 14

%an!!al 1$/1/2*16 Lantai 5 barat


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Leukosit 3,4 ribu/L 4,5-12,5


Hb 13,3 12,-16,

Ht 3 35-4$

%rombosit 6 154-36

'() 1, *-1**

'(H 2,5 26-34

'(H( 34, 32-36

. 11,$ 14

SGPT 4& m/"l 23

%an!!al 1/1/2*16 Lantai 5 barat


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Leukosit 3, ribu/L 4,5-12,5


Hb 13,5 !/"L 12,-16,

Ht 3& # 35-4$

%rombosit 1$ ribu/L 154-36

'() 2,2 +L *-1**

'(H 2,5 p! 26-34'(H( 34,6 !/"L 32-36

. 11,$ # 14

%an!!al 1&/1/2*16 Lantai 5 barat


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Rn'$a%an

Nn. " u,+ #$ %hun& m,uk rumh ,k+% dengnkeuhn demm ,e:k 6 hr+ S"RS& demm n+k %urun&mengg+g+ (;). Demm %urun ,een%r dengn o%-enurun -n, kemud+n n+k g+. B%uk (;)& mu (;)&

nyer+ ke- (;)& -u,+ng (;)& nyer+ uu h%+ (;)& ,e,k (;)&-%ek+e (;) -d derh %ngn ,e:k # hr+ S"RS&rumple leed (;). Ng& N! #38 C1mn%& RR! '6C1mn%& S! 08&33@. Akr d+ng+n (;)& rum-e eede (;).

Leuko,+% ! '&7 r+u1=L& Tromo,+% # r+u1=L& S9OT ! 0mU1d& S9PT ! 6 mU1d. APTT ! 67&4 de%+k& An%+Dengue Ig91Ig" ! -o,+%+


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",h

D>F grde III dengn Dengue Shock Syndrome(DSS)


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An+,+, ",h


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An+,+, k,u,


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ANALISA KASUS (n:u%n)

Akh+rny %er-enuh+h em-% kr+%er+ 2>O un%uk menegkknd+gno,+, D>F& y+%u!Demam&!a"at +emam a$ut& n%r '/4 hr+ +,ny +


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ANALISA KASUS (n:u%n)

Dn erd,rkn der:%ny& -,+en +n+ %ergoong -d

+e&a)at III (Dengue Shock Syndrome* krend+d-%kn keggn ,+rku,+& y+%u nd+ ce-% dn emh&%eknn nd+ menurun ('3 mm>g %u kurng) %u

h+-o%en,+& ku+% d+ng+n dn em& ,er% %m-k ge+,h.


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Rencn Ter-+

Se,u+ dengn -r+n,+- -engo%n -d Demm Dengue& -,+end+er+kn %er-+ %u#&t/ dn %er-+ %m#tmat$. Pen%k,nnd+%u:ukn un%uk menggn%+ keh+ngn c+rn k+% keocorn -,mdn memer+kn %er-+ ,u,%+%u,+ kom-onen drh +mnd+-erukn.

Ter-+ c+rn eru- IFD RL1$ :m un%uk memn%u mengencerknkeken%n drh yng memek% ,eh+ngg ok,+gen d-% %eru, d++rknke ,e%+- ,e %uuh dn ,+ndrom ,yok d-% %er%,+.

Ter-+ ,+m-%om%+k eru- -rce%mo d+er+kn un%uk menurunkndemm& dn ome-roe d+er+kn un%uk mengurng+ nyer+ uu h%+.


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Plannn'

Me+$ament%a:

IFD RL1$:m

ouen 1 #' :m

Nore-+ne-hr+ne 3 mcg %u dou%m+n 3&7mcg

@endn%ron 0C8mg

Ok,+gen ' +%er1men+%

Trn,m+n 0C#

+%. K 0C#Pum-+ce #C63mg

P&'n%%

Ad


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Foo5 u-..H8:

E8.8%8N

:( Lantai 5 ;arat

15-1-2*16 16-1-2*16 1$-1-2*16 1-1-2*16 1&-1-2*16

%8N8 ):%8L % @*/5* mmH!

N @ $ C/i

@ 1 C/i

0 @ 3$, *(

% @ &*/6* mmH!

N @ * C/m

@ 24 C/m

0 @ 3$ *(

% @ &*/6* mmH!

N @ &4 C/m

@ 16 C/m

0 @ 3$,& *(

% @ 1**/6* mmH!

N @ C/m

@ 2*C/m

0 @ 36, *(

7 00/(' 00/(' 00/(' 00/('

7ELH8N

%8'8

emam B sejak

4 >ari 0'0?

'imisan -? 'ual

B, munta> -,

NDeri 7epala B

emam -? 'ual

B, munta> -,

NDeri 7epala -

emam B ta"i

malam? 'ual B,

munta> -, pusin!

B

emam -, sesak

B, batuk B

'8%8 CA (-/-), SI (-/-) CA (-/-), SI (-/-) CA (-/-), SI (-/-) CA (-/-), SI (-/-)

%H870 H @ -/- , .> @ -/- H @ -/- , .> @ -/- H @ -/- , .> @ -/- H @ -/- , .> @ -/-

8;'EN ; @ B ,N% @ - ; @ B ,N% @ - ; @ B ,N% @ - ; @ B ,N% @ -

E70%E':%80 EE'8 @ -/- EE'8 @ -/- EE'8 @ -/- EE'8 @ -/-


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:8N08 00 00 00 00

%E8: ro :(

:)9 L/6jam

)oluAen / 12 jam

Norepinep>rine *,1

m

ksi!en 2 liter/menit

%ransamin 3C1

)it? 7 3C1

umpi


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Angk In,+den DBD -er #33.333 -enduduk d+Indone,+ %hun #$8/'33. (8)


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GEJALA KLINIS

GFase Febris

Pd


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P%ogene,+,


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D+gno,+,

"enuru% 2>O& kr+%er+ yng hru, d+-enuh+ un%uk menegkkn d+gno,+, DBDdh ,eg+ er+ku%!(6)

"n+


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K,+O& #4)& y+%u!DBD 9rde I ! Demm d+,er%+ ge: %+dk kh, dn ,%u/

,%uny mn+g %u h+-o%en,+& ku+% yng d+ng+n dnem ge+,h. (Der:% III dn I).


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In+$a% #ulan'kedn umum +k dn m, kr+,+, %eh eru

%u 4 hr+ ,e:k -n,.kedn umum +k d+%nd+ dengn! n


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Km#l$a%Beer- kom-+k,+ yng d-% d+%+mukn oeh

DBD dh ,eg+ er+ku%! -erdrhn

g,%ro+n%e,%+n m,+


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presentasi laporan kasus dss

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