DBD Zika

DBD
atau
Zika
Mendiagnosisinfeksivirus
(DBD?Zika?)
ErniJuwitaNelwan
[email protected]
DemammendadakAnggisejak1harisebelum
masukrumahsakit.
Saatdirawatsuhu38,40Cdanterusmengalami
peningkatanhinggaterjadipuncakdemampada
harikeAgadengansuhu39,70C.Padahari
perawatanke-4,suhuturunhingga37,40Cdan
AdakdiikuAkenaikansuhupadapemantauan
hari-hariberikutnya.
Memahami:
-patogenesis
-patofisiologis
DiagnosisofDHF
Allofthese:
}  AcuteonsetoffeveroftwotosevendaysduraAon
}  HaemorrhagicmanifestaAons:tourniquettest,
petechiae,ecchymosesorpurpura,orbleedingfrom
mucosa,gastrointesAnaltract,injecAonsites,orother
locaAons
}  Plateletcount≤100000cells/mm3
}  ObjecAveevidenceofplasmaleakage:
}  –↑haematocrit/haemoconcentraAon≥20%frombaseline
ordecreaseinconvalescence,
}  Evidenceofplasmaleakage:pleuraleffusion,ascitesor
hypoproteinaemia/albuminaemia
WHOSEARO.ComprehensiveguidelinesforprevenAonandcontrolofdengueandDHF.2011
HLA-A2
Epidemiologic Factors for Emerging and Spreading of Dengue Hemorrhagic Fever
Non-specificcons4tu4onalsymptomsobservedinhaemorrhagicfever
pa4entswithdengueandchikungunyavirusinfec4ona
Criteria
Injectedpharynx
Vomi4ng
Cons4pa4on
Abdominalpain
Headache
Generalizedlymphadenopathy
Conjunc4valinjec4on
Cough
Rhini4s
Maculopapularrash
Myalgia/arthragia
Enanthema
Abnormalreflex
Diarrhoea
Palpablespleen
Coma(IChemorrhage)
DHF(%)
96.8
57.9
53.5
50.0
44.6
40.5
32.8b
21.5
12.8
12.1b
12.0b
8.3
6.7
6.4
6.3c
3.0
Chikungunya
Fever(%)
90.3
59.4
40.0
31.6
68.4
30.8
55.6b
23.3
6.5
59.4b
40.0b
11.1
0.0
15.6
3.1c
0.0
aModifiedfromNimmannityaSetal.AmericanJournaloftropicalmedicineandhygiene,1969,18:954-97114
bSta4s4callysignificantdifference.
CInfantsunder6months
PanashilangAmbulsejak3mingguyanglalu.
3mingguyanglalu,badanpanashilangAmbul,
Adaktentupagi,siang,malam.Menggigildan
didapatkanhari-haribebaspanas.Panasturun
biladiberiobatlalukemudiannaiklagi.
Sakitkepala,mual,Adakmuntah,Adakmimisan,
Adakbatuk. PerjalanankeAmbon10bulanyanglalu,sakit
malariadandinyatakansembuh.Tidakpernah
mengalamiseperAinisebelumnya.
VIRUS
Q