7/21/2019 Demam Tifoid 1

http://slidepdf.com/reader/full/demam-tifoid-1-56e0cebd7ab99 1/20

Demam

TifoidJayanti Dwi Cahyani (11

Kafia Rakhmah (11020

Luthfia Rozanah (110

Putri Mutiara (1102

Tai! (1102011

7/21/2019 Demam Tifoid 1

http://slidepdf.com/reader/full/demam-tifoid-1-56e0cebd7ab99 2/20

BACKGROUND

Demam tifoidDemamenteric

Endemik (90%)

Mda!men"ar

#a$a

7/21/2019 Demam Tifoid 1

http://slidepdf.com/reader/full/demam-tifoid-1-56e0cebd7ab99 3/20

Demam tifoid

nfek&i &i&temik akt  Salmonella typhi ata paratyphi &erot'e ABC

Enteric fe*er tif& aratif& a$domina"i&

Tifoid karier fece&+ rin men,andn, S.typhi - ta!n a&ca t'!oid fe*ertana ,e.a"a k"ini&

7/21/2019 Demam Tifoid 1

http://slidepdf.com/reader/full/demam-tifoid-1-56e0cebd7ab99 4/20

/ato,ene&i& atofi&io"o,i

7/21/2019 Demam Tifoid 1

http://slidepdf.com/reader/full/demam-tifoid-1-56e0cebd7ab99 5/20

7/21/2019 Demam Tifoid 1

http://slidepdf.com/reader/full/demam-tifoid-1-56e0cebd7ab99 6/20

K"ini&

nk$a&i-01-2 !ari

Min""u 1 Min""u 2

Demam intermitten (3ore 4 ma"am)N'eri kea"a/&in,N'eri ototAnorek&ia

Ma" mnta!O$&tia&i + diare/era&aan tidak enak ertBatkEitak&i&

DemamBradikardi re"ati*e ( T -↑ 0  nadi tidak

56)↑

7ida! $er&e"at (kotor ten,a! tei.n, mera! tremor)

8eatome,a"i3"enome,a"iMeteroi&m&Gan,,an menta"

7/21/2019 Demam Tifoid 1

http://slidepdf.com/reader/full/demam-tifoid-1-56e0cebd7ab99 7/20

Dia,no&i&

/emerik&aan rtin

U.i ida"

U.i t$e6

U.i t'!idot

U.i ,M di&tick

K"tr dara!

7/21/2019 Demam Tifoid 1

http://slidepdf.com/reader/full/demam-tifoid-1-56e0cebd7ab99 8/20

/emerik&aan rtin  dara! erifer "en,ka  "ekoenia norma" "eko&ito&i&

Anemia rin,an

Trom$o&itoenia

8itn, "eko&it  aneo&inofi"ia "imfoenia

7ED menin,kat

3GOT 3G/T naik

7/21/2019 Demam Tifoid 1

http://slidepdf.com/reader/full/demam-tifoid-1-56e0cebd7ab99 9/20

ida" Detek&i anti$od' ter!ada 3:t'!i

3emakin tin,,i titer kemn,kinan terinfek&i menin,kat

Ak!ir min,, ertama demam  menin,kat ceat  &amai ncak min,, ke 2  teta tin,,i $e$eraa min,,

Akt a,,"tinin 0 a,,"tinin 8

3em$!  a,,"tinin O &t"! 21; $"an a,,"tinin 8 91-< $"an

Ada $e$eraa faktor 'an, memen,ar!i .i ida" 'ait=

/en,o$atan dini den,an anti$iotic

Gan,,an em$entkan anti$odi dan em$erian kortiko&teroid #akt en,am$i"an dara!

Daera! endemik ata non1endemik

Ria'at *ak&ina&i

Reak&i anamne&tic 'ait enin,katan titer a,"tinin ada infek&i $kan demam tifoid

aki$at infek&i demam tifoid ma&a "a" ata *ak&ina&i

>aktor teknik emerik&aan antar "a$oratorim aki$at a,"tina&i &i"an, dan &train3a"mone""a 'an, di,nakan ntk &&en&i anti,en

7/21/2019 Demam Tifoid 1

http://slidepdf.com/reader/full/demam-tifoid-1-56e0cebd7ab99 10/20

U.i t$e6

U.i &emi1kantitatif ko"ometrik ceat mda!

Detek&i anti$od' anti 31t'!i 09

8a&i" = (?)  infek&i &a"mone""a ,ro D

nfek&i 3:arat'!i  !a&i" (1)

7/21/2019 Demam Tifoid 1

http://slidepdf.com/reader/full/demam-tifoid-1-56e0cebd7ab99 11/20

U.i t'!idot

Detek&i anti$od' ,M dan ,G

8a&i" = (?)  <1@ !ari &ete"a! infek&i identifika&i &e&ifik ,M ,G

3en&iti*ita& 95%

3e&ifita& ;:%

Efi&ien&i .i 52%

7/21/2019 Demam Tifoid 1

http://slidepdf.com/reader/full/demam-tifoid-1-56e0cebd7ab99 12/20

U.i ,M di&tick

Mda! dan ceat (- !ari)

Akra&i - min,, &ete"a! ,e.a"a

K"tr dara!

8a&i" = (?)  demam tifoid (1)  tidak &in,kirkan demam tifoid

>a"&e (1) =

-: Terai anti$iotic

<: o"me dara! kran,

@: Ria'at *ak&ina&i

2: /en,am$i"an dara! &ete"a! min,, ertama

7/21/2019 Demam Tifoid 1

http://slidepdf.com/reader/full/demam-tifoid-1-56e0cebd7ab99 13/20

TATA7AK3ANA

-: /enata"ak&anaan Umm

<: /enata"ak&anaan ada Demam Tifoid Karier

7/21/2019 Demam Tifoid 1

http://slidepdf.com/reader/full/demam-tifoid-1-56e0cebd7ab99 14/20

/enata"ak&anaan mm

&tira!at daneraatan• Ce,a! kom"ika&i

• Memerceaten'em$!an

• Ke$er&i!an temat tidrakaian daner"en,kaan

Diet dan teraienn.an,• Diet $$r &arin,  

Diet $$r ka&ar  na&i

antimikro• K"oramfeniko"• Tiamfeniko"

• Kotrimok&ao"• Ami&i"in am• 3efa"o&orin ,o• >"orokino"on• aitromi&in

7/21/2019 Demam Tifoid 1

http://slidepdf.com/reader/full/demam-tifoid-1-56e0cebd7ab99 15/20

Demam tifoid ada anita !ami"

Trime&ter @  tidak k"oramfeniko"  &e$a$kan art& rematre kematianfet& intraterine ,re' &'ndrome neonate&

Trime&ter -  tidak tiamfeniko"  terato,enik ada fet&

>"orokino"on kotrimok&ao"  tidak $o"e!

O$at i"i!an = ami&i"in amok&i&i"in &eftriak&on

7/21/2019 Demam Tifoid 1

http://slidepdf.com/reader/full/demam-tifoid-1-56e0cebd7ab99 16/20

7/21/2019 Demam Tifoid 1

http://slidepdf.com/reader/full/demam-tifoid-1-56e0cebd7ab99 17/20

Demam Tifoid Karier

Tata"ak&ana

Anti$iotik $erda&arkan en'"it

Dia,no&i&Biakan fe&e& +rin  Kman Salmonella typhii

Tanda k"ini& infek&i (1)

Biakan acak &eria" min ; ka"i

 tidak ditemkan S.typhi

Demam Tifoid Karier>e&e& + rin men,andn, 3:t'!i  - ta!n a&ca demam t'!oid tana di&erati ,e.a"a

7/21/2019 Demam Tifoid 1

http://slidepdf.com/reader/full/demam-tifoid-1-56e0cebd7ab99 18/20

Kom"ika&i

nte&tina"

/erdara!aninte&tina"

/erfora&i &&

ek&trainte&tina"

Kom"ika&i!emato"o,i

8eatiti&tifo&a

Miokarditi&

Nero&ikiatri(tifoid tok&ik)

7/21/2019 Demam Tifoid 1

http://slidepdf.com/reader/full/demam-tifoid-1-56e0cebd7ab99 19/20

/ence,a!an

dentifika&i dan eradika&i 3a"mone""a t'!i

/ence,a!an tran&mi&i "an,&n, dari a&ien

/rotek&i ada 'an, $ere&iko terinfek&i

ak&ina&i

7/21/2019 Demam Tifoid 1

http://slidepdf.com/reader/full/demam-tifoid-1-56e0cebd7ab99 20/20

/ro,no&i&

itam = Bonam

>n,&ionam = Bonam

3anationam = D$ia ad $onam (en'akit daat $er"an,)

/ro,no&i& &an,at ter,antn, ada kondi&i a&ien &aat datan, ada tidakn'a

kom"ika&i dan en,o$atann'a: