Git Group 14 Problem 3 2011

7/24/2019 Git Group 14 Problem 3 2011

1/72

GROUP14

PROBLEM 3GIT 2011

Tuesday, 13 1


2/72

GROUP 14

Tutor dr! "#a$"#aLeader Joyce Gunawan Putri 405090232Se%retary Deviana Putri 405090181S%r#ber Budianto 405090095&re' Ganjar Nugraha 40500023

!a"ri #i$%i 405080041 !a&&y Novi !yah #a&i' 405080115 Dede( Putrawan 4050801)8 !a'ot 4050900)8

*aryn +iranda 405090125 #ui ,ee !ha( 405090229 Nadia -&ena Pa'udji 40509023) *e&een .ei !etiawan 405090239

2


3/72

PROBLEM 3

/ou receive a caa& $ro' the 'other o$ a reviou&yhea&thy 5yearo&d "oy ive day ago hedeve&oed a te'erature o$ 40 6 * a"do'ina&dico'$ort nauea and contiation $or 2 day7he 'other au'ed he had the a'e y'to'

&i(e hi aunt or 'any other chi&dren in hi daycare center

#owever today he deve&o diarrhea 3 ti'e and

ee' 'ore irrita"&e /ou are a(ing a"out hicurrent hydration tatu the 'other reort thathe vo'it evera& ti'e and a&'ot ta(e ni& "y'outh /ou te&& her to ca&& the a'"u&ance and

then noti$e the &oca& hoita& e'ergency centero$ hi i''inent arriva& 3


4/72

MI() M*

+ E*R$OL) BO

+ )* *GOTEMPER*TURE o-

40 . &

*B)OMI(*L)IS&OM"ORT

(*USE*&O(STIP*TIO(

"OR 2 )*S

/ISTOR /*)S*ME

SMPTOMSLIE /IS*U(T OR

M*( OT/ER&/IL)RE( I(/IS )* &*RE

&E(TERTO)*

)I*RR/E* 3TIMES *()

MOREIRRIT*BLE

T*ES (IL B

MOUT/

))TPOI) "EER,

G*STROE(TERITIS,/EP*TITIS,

P*R*TPOI) "EER,)B)

4


5/72

LE*R(I(G OBE&TIE

1 Decri"e the a&'one&&oi

2 Decri"e the tyoid and aratyoid

5


6/72

)


7/72

!cientic c&aication

Do'ain Bacteria

Phy&u' Proteo"acteria

*&aGa''aroteo"acteria

:rder -ntero"acteria&e

a'i&y -ntero"acteriaceae

Genu salmonellasalmonella


8/72

Med#%ay #mportat Samoea Spe%#es

are

a; !a&'one&&a cauing enteric $everery 'a&&

Gra'negative .odhaed?"aci&&i 'oti&e "acteriu'

Nonor'$or'ing

Pro(aryotic ce&& @re&icate Auic(&y;

Noncau&ate ecet !a&'one&&atyhi

Peritrichou Cage&&a acu&tative anaero" =ntigen ?=HD! :ther i''une deciencie and chronic granu&o'atou

dieae

H''unoureive and corticoteroid theray +a&ignancie eecia&&y &eu(e'ia and &y'ho'a #e'o&ytic ane'ia inc&uding ic(&e ce&& dieae

'a&aria and "artone&&oi *o&&agen vacu&ar dieae

HnCa''atory "owe& dieae =ch&orhydria or antacid 'edication ue H'aired intetina& 'oti&ity !chitoo'iai 'a&aria +a&nutrition

21


22/72

*&inica& +ani$etation

=cute -nteriti7he 'ot co''on c&inica& reentation o$

a&'one&&oi i with acute enteriti

=$ter an incu"ation eriod o$ )L2 hr @'ean 24

hr; there i an a"rut onet o$ naueavo'iting and cra'y a"do'ina& ain ri'ari&yin the eriu'"i&ica& area and right &owerAuadrant $o&&owed "y 'i&d to evere watery

diarrhea and o'eti'e "y diarrhea containing"&ood and 'ucu

= &arge roortion o$ chi&dren are $e"ri&ea&though younger in$ant 'ay ehi"it a nor'a&or u"nor'a& te'erature 22


23/72

*&inica& +ani$etation

=cute -nteriti !y'to' uua&&y u"ide within 2L day in

hea&thy chi&dren and $ata&itie are rare

#owever o'e chi&dren deve&o everedieae with a etice'ia&i(e icture @high$ever headache drowine con$uion'eningi'u ei%ure a"do'ina& ditention;

7he too& tyica&&y contain a 'oderate nu'"ero$ o&y'orhonuc&ear &eu(ocyte and occu&t"&ood +i&d &eu(ocytoi 'ay "e detected

23

T b # )# I d d b S


24/72

Tabe!#%a )#seases Idu%ed by Samoeae!

-nteric ever !etice'ia -nteroco&iti

Hncu"ation

eriod

L20 day >aria"&e 8L48 hour

:net Hnidiou ="rut ="rut

ever Gradua& thenhigh &ateauwith tyhoida&

tate

.aid rie theni(ing eticte'erature

Fua&&y &ow

Duration o$dieae

!evera& wee( >aria"&e 2L5 day

Gatrointetina&y'to'

:$ten ear&ycontiationI

&ater "&oodydiarrhea

:$ten none Naueavo'iting

diarrhea atonet

B&ood cu&ture Poitive in rtto econd wee(o$ dieae

Poitive duringhigh $ever

Negative

!too& cu&ture Poitive $ro' Hn$reAuent&y Poitive oon24


25/72

25

7 h id


26/72

Humans are the only hosts Disease results from ingestion of contaminated food & water

Prolonged fever after incubation period of 3-2 days

!on specific symptoms" chills# headache# sweating# cough# malaise# arthralgias

$% symptoms" anoreia# nausea# vomiting# diarrhea# constipation# abdo'pain

Physical findings" rose spots# hepatosplenomegaly# epistais# relative bradycardia'

(omplications" intestinal perforation# $% hemorrhage due to ulceration & necrosis of infiltratedPeyer)s patches

(arier" -*+ patients associated w, disease in the bladder# biliary# or $%

7yhoid ever L:verview

#arri2)


27/72

-PHD-+H:,:G/

7yhoid $ever occur wor&dwide ri'ari&y indeve&oing nation whoe anitary conditionare oor

7yhoid $ever i ende'ic in =ia =$rica ,atin

='erica the *ari""ean and :ceania "ut 80o$ cae co'e $ro' Bang&adeh *hina HndiaHndoneia ,ao Nea& Pa(itan or >ietna'

ithin thoe countrie tyhoid $ever i 'ot

co''on in underdeve&oed area 7yhoid $ever in$ect rough&y 21) 'i&&ion eo&e

@incidence o$ 3) er 1000 ou&ation; and (i&&an eti'ated 200000 eo&e every year

2


28/72

28


29/72

Incubation Week 1 Week 2 Week 3 Week 4 Post

Systemic Recovery phase

or death (15% o

untreated cases!

1"%#2"%

re$apse 3%#

4% chronic

carriers

$onterm

neuro$o&ic

se'ue$ae

(etreme$y

rare!&a$$b$adder

cancer

(RR)1*+

carriers!

Step$adder

ever pattern or

insidious onset

ever

,ery commona ,ery common

-cute hi&h ever ,ery rareb

.hi$$s -$most a$$c

Ri&ors /ncommon-noreia -$most a$$

0iaphoresis ,ery common

euro$o&ic

a$aise -$most a$$ -$most a$$ yphoid state

(common!Insomnia ,ery common

.onusionde$irium

.ommond

,ery common

Psychosis ,ery rare .ommon

.atatonia ,ery rare

eadache

(usua$$y mi$d!

,ery common

enin&ea$ si&ns Raree

RareParkinsonism ,ery rare

29


30/72

I%ubat#o

:ee; 1 :ee; 2 :ee; 3 :ee; 4 Post

Ear, ose, ad t


31/72


Sharp ri&ht

$o6er

'uadrant

pain

Rare

7astrointesti

na$

hemorrha&e

,ery rare

usua$$y trace

,ery common

intestina$peroration

Rare

epatosp$en

ome&a$y

.ommon

8aundice .ommon

7a$$b$adder

pain

,ery rare

/ro&enita$

/rinary

retention

.ommon

ematuria Rare

Rena$ pain Rare 31


32/72


uscu$oske$eta$

ya$&ias ,ery rare

-rthra$&ias ,ery rare

Rheumato$o&ic

-rthritis

($ar&e 9oint!

:treme$y rare

0ermato$o&ic

Rose spots Rare

isce$$aneous

-bscess

(any6here!

:treme$y

rare

:treme$y

rare

:treme$y

rare

aery %ommo Symptoms o%%ur # 'e o=er #matey 6+7$+78!bery rare Symptoms o%%ur # ess t


33/72

33


34/72

34

M*(I"EST*SI LI(IM*(I"EST*SI LI(I


35/72

Ink Week I Week 2 Week 3 Week 4

;$ood

cu$ture


36/72

B&ood cu&ture in 7yhoid$ever

Hn =du&t 5 10 '& o$ B&ood i co&&ected"y veneuncture inocu&ated into 50 L

100 '& o$ Bi&e "roth @ 05 ; !evera& other 'edia are avai&a"&e ued

a er the avai&a"i&ity o$ 'ediu' to uittheir &a"oratory condition

3)


37/72

Bood &utures # Typ


38/72

Idet#C%at#o o-Samoea

!u" cu&ture are done a$ter overnightincu"ation at 30cand u"cu&ture

are done on +ac *on(eyO agar !u"cu&ture are reeated uto 10

day a$ter $uther incu"ation

38


39/72

!a&'one&&a on +ac *on(eyOagar

39


40/72

!a&'one&&a on ,D agar

40

Id #- # E #


41/72

Idet#-y#9 Eter#%Or9a#sms

Ho&ate which are Non &actoe $er'enting

+oti&e Hndo&e oitive

Freae negative

er'ent G&ucoe+annito&+a&toe Donot $er'ent ,actoe !ucroe

7yhoid "aci&&i are anaerogenic

!o'e o$ the Paratyhoid $or' acid and ga

urther identication done "y &ide agg&utinationtet

41


42/72

S#de a99ut#at#o

tests Hn &ide agg&utination

tet a (nown eru'and un(nown cu&ture

io&ate i 'iedc&u'ing occurwithin $ew 'inute

*o''ercia& era are

avai&a"&e $ordetection o$ =B*1*2D and -

42


43/72

&ot %uture

*&ot cu&ture are 'ore roductive inyie&ding "etter reu&t in io&ation

= "&ood a$ter c&otting the c&ot i &yedwith !treto(inae "ut eenive toer$or' in deve&oing countrie

43


44/72

Ba%te; ad Rad#ometr#% basedmet


45/72

Ot


46/72

-'erging +ethod inDiagnoi o$ -nteric $ever

Detection o$ circu&atingantigen "y &o$a99ut#at#o 'ethodwith ue o$ *owan

train !tahy&ococcucoated with anti"odie

P*. T


47/72

)#a9os#s o- &arr#ers

Fe$u& in u"&ic hea&th uroe

Fe$u& in creening $ood hand&ercoo( to detect carrier tate

7yhoid "aci&&i can "e io&ated $ro'$ece or $ro' "i&e airate

Detection o$ >i agg&utinin in theB&ood can "e deter'inant o$ carriertate

4


48/72

:#da Test

Hn 189) ida& = ro$eor o$ atho&ogyand interna& 'edicine at the Fniverityo$ Pari @1911L29; he deve&oed arocedure $or diagnoing tyhoid $ever"aed on the $act that anti"odiein the"&ood o$ an in$ected individua& caue

the "acteria to "ind together intoc&u' @the ida& reaction;

48
http://www.britannica.com/EBchecked/topic/643157/Fernand-Isidore-Widalhttp://www.britannica.com/EBchecked/topic/643157/Fernand-Isidore-Widal


49/72

)#a9os#s o- Eter#% "e=erWidal test

!eru' agg&utinin raie a"rut&y during the 2ndor3rdwee(

7he wida& tet detect anti"odie againt : and #antigen

T'o serum spe%#mes obta#ed at #ter=aso- D 10 days to read t


50/72

S#9#C%at T#ters


51/72

Widal test Still a populartest

7he ida& tet @ida& agg&utination reaction; iroutine&y ractied $or the erodiagnoi o$ tyhoid$ever "y 'ot o$ the &a"oratorie !evera& wor(er haveereed dou"t regarding the re&ia"i&ity o$ the tet

!evera& $actor have contri"uted to thi uncertainty7hee inc&ude oor&y tandardied antigen theharing o$ antigenic deter'inant with other!a&'one&&ae and the eEect o$ i''uniation with 7=Bvaccine =nother 'ajor ro"&e' re&ate to the diQcu&ty

o$ interreting ida& tet reu&t in area where!a&'one&&a tyhi i ende'ic and where the anti"odytitre o$ the nor'a& ou&ation are o$ten not (nown

51


52/72

L#m#tat#os o- :#da test

*&aica&&y a $our$o&d rie o$ anti"ody in airedera ida& tet i conidered diagnotic o$tyhoid $ever #owever aired era are o$ten

diQcu&t to o"tain and ecic che'otheray hato "e intituted on the "ai o$ a ing&e ida&tet urther'ore in area where $ever due toin$ectiou caue i a co''on occurrence the

oi"i&ity eit that $a&e oitive reaction'ay occur a a reu&t o$ nontyhoid

52


53/72

DH-.-N7H=, DH=GN:!H!

Paratyphoids A, B & CR 7he &a"oratory iuua&&y reAuired a the na& authority 7hearatyhoid tend to run a 'i&der coure withro$ue roe ot

Salmonella inection and gastroenteritisR !a&'one&&ae the dyentery grou and

tahy&ococci 'ay occaiona&&y caue aninvaive i&&ne ree'"&ing tyhoid $ever with

"actere'ia Fua&&y however thegatrointetina& y'to' are 'ore acutethan the genera& 'ani$etation and theyreia 'uch &ower and o$ horter duration

53


54/72


!ther diseases in di"erential diagnosisa!Maar#aR 7hi 'ay "e 'ita(en $or tyhoid in

countrie where "oth are ende'ic = hitory o$reviou attac( the 'ore raid onet in 'a&ariathe hivering and weating the high ear&yyreia the re&ative in$reAuency o$ a"do'ina&y'to' and ign and a oitive "&ood &idea&& oint to a diagnoi o$ 'a&aria

b! IueHaR HnCuen%a 'ay a&o "e con$uedwith tyhoid "ut i uua&&y o$ 'uch 'ore raidonet with high te'erature evere ore throatcough and the a"ence o$ a a&a"&e &een androe ot

54


55/72


%! Ba%#ary dyseteryR 7hi dieae e&do' caue 'uchdiQcu&ty in diagnoi 7he onet i uua&&y acute with evere"&ood diarrhoea a&though in 'i&d cae the "&ood 'ay "ea"ent Diarrhoea with "&ood i rare in ear&y tyhoid 7he ignand y'to' in dyentery are uua&&y a"do'ina& and re'aino the 'enta& tate and chet "eing c&ear

d! Typ


56/72

Dengue ever

Dengue $ever i viru L "aeddieae read "y 'oAuitoe

+ot co''on&y the 'oAuito =ede=egyti

5)


57/72

!HGN =ND !/+P7:+P

ever

#eadache

+uc&e and joint ain Nauea ? vo'iting

.ah

#e'orrhagic 'ani$etation

5

*riteria uect o$ dengue


58/72

4 necceary criteria=**HN-!

.outine tyhoid vaccination i indicated $oraccine are not aroved $or ue chi&drenyounger than 2 year

)


68/72

*o'&ication

Itest#a %omp#%at#os

Hntetina& "&eeding

Hntetina& er$oration

Para&ytic i&eu

&omp#%at#ose;stra#test#a

*ardiovacu&ar

Documents

Git Group 14 Problem 3 2011