TORCH Repro 2012

8/9/2019 TORCH Repro 2012

1/44


2/44

DefnisiT= TOXOPLASMA GONDIIO=OTHERS (HEPATITIS B, SIFILIS,

VARICELLA ZOSTER, HIV, PARVO VIRUS)

R=RUBELLAC=CITOMEGALOVIRUS

H= HERPES SIMPLES VIRUSHBV !i"#s $es%", &i'% %*# ene$#s s%+%"

'%"% *-%sen&%, *en#-%"%n -e+%& *e"'%"%%n s%%&e-%i"%n $%.i/%ni0sin&esis


3/44

RUBELLA

DEFINISIR#$e--% (1%*% 2e"%n / 1%*% 3 %"i%n)

*en.%i& 'e% %#& .%n4 'i&%n'%i 0-e "#%#-i&

Me"#*%%n s%-% s% '%"i en% in5esi .%n4'i&%n'%i 'en4%n "#% #-i&( e%s-es, s1%"-e&5e!e", "#$e--%, '#e6s 'ise%se, f5&'ise%se/e".&e% in5e1&i0s#, %n' "0se0-%,)

Rin4%n

e%i-%n 7 e4#4#"%n, %-50"%si 0n4eni&%-


4/44

RUBELLA8 Rubella mean small red8 Spherical,

8 70 nm in diameter,

8 nucleocapsid has 42capsomeres.

8 Genome: positive-sense,sinle-stranded R!", ##$#2

%b in si&e.8 'nvelope.

8 (hree or )our ma*orstructural pol+peptides, to

l+cos+lated.8 Re lication: c to lasm.


5/44

M0"50-04iF%i-i &04%!i"i'%eGen#s R#$i!i"#sM%n#si% e"#*%%n s%s%n.% in%n4'i-%"%n e-%-#i direct droplet contact from

nasopharyngeal secretions, 'i#-%i 'en4%n&"%s "es*i"%&0"i#s Vi"#s $e"e*-i%si 'i e-en2%" -i5e upper

respiratory tract en.e$%" se1%"%e%&04enCongenital infection&e"2%'i se-%% %&e"n%-

!i"ei% ene$#s *-%1en&%:


6/44

P%&04enesis

aternal viremia in)ection o) theplacenta and )etus.

(he rubella virus is enerall+nonc+tol+tic, alloin cell survival but

resultin in persistentl+ in)ected cellsith a decreased roth rate andshortened survival time.

(he roth rate o) in)ected cells isreduced, resultin in )eer numbers o)cells in aected orans at birth.

Rubella virus particles ma+ be retained

in secluded sites
http://torch%20ku.ppt/http://torch%20ku.ppt/


7/44

ATOGENESIS&e. 1%n #n'e"40 "e1#""en& *e"i0's 05&e. 1%n #n'e"40 "e1#""en& *e"i0's 05

in1"e%se' !i"#s *"0'#1&i0n %n' "e*-i1%&i0n:in1"e%se' !i"#s *"0'#1&i0n %n' "e*-i1%&i0n:Be50"e &e 'e!e-0*en& 05 &e %&e"n%-Be50"e &e 'e!e-0*en& 05 &e %&e"n%-

i#ne "es*0nse, &e !i"#si#ne "es*0nse, &e !i"#s s*"e%'s &"0#4s*"e%'s &"0#4&e $-00's&"e%&e $-00's&"e%%n' %. %;e1& #-&i*-e%n' %. %;e1& #-&i*-e%&e"n%- &iss#es, in1-#'in4 &e *-%1en&%:%&e"n%- &iss#es, in1-#'in4 &e *-%1en&%:

!%s1#-%" .*0


8/44

MANIFESTASILINIP0s&n%&%- $i%s%n.% %s.*&0%&i1

An%9%n% $i%s%n.% 4e2%-% *"0'"0%- $e"#*%malaise, fever and anorexia:

De+%s% ##n.% -e$i *%"% '%"i*%'% %n%9%n%

-%ssi1 "#$e--%

lo rade )ever,l+mphadenopath+ daerah posterior cervicaldan occipital , and rash

R%s &e"2%'i se&e-% >? '%.s se&e-% 5%se in!%si !i"#s,#2#' e-%in%n #-i& $e"#*% e".&e%&0#s,%1#-0*%*#-%" 'i#-%i '%"i +%2% e#'i%nen.e$%" e $%'%n se-%% 3 %"i

%'%n4 'i2#*%i %"&"i&is '%n *e"n% 'i-%*0"%n%'%n.% &"0$0si&0*eni


9/44

CONGENITAL RUBELLA SINDROME

(CRS)Pe"&%% %-i 'i'e&esi &%#n >@?> *%'%

e2%'i%n e*i'ei 'i A#s&"%-i%

De"%2%& e"#s%%n .%n4 'i&i$#-%n *%'%2%nin &e"4%nn4 *%'% &"ies&e" $e"%*% i$#&e"in5esiP%'% &"ies&e" %+%- '%*%& &i$#- 'e5e

*%'% 9 e%i-%n, %$0"s s*0n&%n&e"2%'i *%'% %s#s


10/44

"/1R"(1! ! 31!G'!("/5'//" S6!R1'B"%in (s%-- $"%in sie, i1"01e*%-i,

in&"%1"%ni%- 1%-1if1%&i0n)E.e ( 1%&%"%"%1&, i1"0*&%-i%)E%" ( e%"in4 'e5e1&, 0"4%n 05 10"&i %;e1&e'

He%"& (*%&en& '#1s %"&e"i0s#s, *%&en&in&e"!en&"i1#-%" se*)Li!e", S*-een (e*%&0s*-en0e4%-i,

&"0$01.&0*eni1 *#"*#"%, %nei%)

Gene"%- (-0+ $i"& +ei4&, in1"e%se' in5%n&0"&%-i&.)

M0s& 05 &ese 10*-i1%&i0ns 'e!e-0* in in5%n&s$0"n &0 0&e"s +0 %1#i"e "#$e--% in5e1&i0n

'#"in4 &e f"s& > +ees 05 *"e4n%n1.:


11/44

DIAGNOSISR#$e--% !i"#s $# -%$%& *%'% #-" 2%"in4%n,

e5e CPE "en'%

2%"%n4 'i*%%iEIA (Enzyme Immuno Essay) 'i2#*%i I4 M .%n4'%*%& 'i'e&esi ? %"i se&e-% &e"2%'i "%s #-i&I4 G *%'% *en'e"i&% $i%s%n.% $e"&%%n se##" i'#*De&esi A#& R#$e--% 2i% 'i&e#%n 7en%i%n ? < &i&e" %n&i$0'i I4G &i&e" %n&%"% e%'%%n

%#& '%n 5%se 0n!%-es1en& *%'% se"# *%sien(Se"# se$%in.% 'i%$i- %n&%"% %"i 9> se&e-% "%s'%n 'i#-%n4 93 in44# e#'i%n)

A'%n.% I4M s*esif "#$e--%Is0-%si !i"#s e-%-#i #-" 2%"in4%n *0si&i5

R#$e--%(se"e& n%s%-, $-00', &"0%&, #"ine, 0"1e"e$"0s*in%- #i' (CSF),##n.% !i"#s 'iis0-%si '%"ise"e& *%".n4 > in44# se$e-# "%s '%n in44#se&e-% "%s)

P0-.e"%se 1%in "e%1&i0n (PCR)


12/44

TERAPITi'% %'% &e"%*i .%n4 s*esif self

limiting disease

Te"%*in.% $e"si5%& s#*0"&i5V%sin%si #n *en1e4%%n *en.%i&

J%ni&% %i- e"#*%%n 0n&"% in'i%si!%sin

J%ni&% .%n4 s#'% 'i!%sin%si 'i%n2#"%nen#n44# se-%% 3 $#-%n ses#'%!%sin%si #n %i-


13/44

CITOMEGALOVIRUSC.&0e4%-0!i"#s (CMV) en4in5esi %n#si%se#% ##", se#% e&ni, $e"$%4%i &in4%&s0si%- e0n0i, se"&% $e"$%4%i -%&%" $e-%%n4s0si%- $#'%.% .%n4 $e"$e'%

U#n.% in5esi $e"si5%& %si&0%&i

In5esi se"i#s *%'% 2%nin, ne0n%s, %#*#n

*en'e"i&% i#n010*"eie'


14/44

T"%nsisiT"%nsisi e-%-#i contact with a person

excreting the virus in saliva, urine, or bodilyuids

C0n4eni&%- CMV in5e1&i0n ##n.% 'i%si-%n'%"i transplacental transmissionVi"#s 2#4% '%*%& 'i-%"%n e-%-#i

transmitted sexually, via organ transplants,

transplacentally, via breast mil!, '%n *e"n%'i-%*0"%n via blood transfusion (esi*#n

2%"%n4):


15/44


16/44

CMV Inclusion Bodies

Intranuclear and oval

owls-eye shape


17/44

3/!3"/"!'S("(1!S3onenital in)ection

IUGR, -0+ $i"&+ei4&

i1"01e*%-., Hi'"01e*%-#s

in&"%1"%ni%- 1%-1if1%&i0ns, 10"i0"e&ini&is,en&%- %n' 0&0" "e&%"'%&i0n, sens0"ine#"%-'ef1i&s, e*%&0s*-en0e4%-., 2%#n'i1e,

e0-.&i1 %nei%, %n' &"0$01.&0*eni1*#"*#"%: (F0+-e" %n' %ss01i%&es, >@@):

B"%in (s%-- $"%in sie)


18/44

Ven&"i1#-0e4%-.%n' 1%-1if1%&i0ns05 10n4eni&%-CMV


19/44

>erinatal in)ectionT"%nsisi &e"2%'i '%"i %&e"n%- se1"e&i0ns,

in4es&i0n 05 $"e%s& i-, %&%# '%"i $-00'*"0'#1& &"%ns5#si0nsIn5esi &%*% se&e-% #si% 3 in44# %&%# 3

s%*%i $#-%nSe"in4%-i $e"si5%& %s.*&0%&i1, %'%n4 2#4%

en4%si-%n 4e2%-% .%n4 $e"!%"i%siSin'"0% ##n.% $e"%i&%n 'en4%n

e*%&0s*-en0e4%-., %$n0"%- $-00' 10#n&s'en4%n -.*0*eni%, ne#&"0*eni% %n'&"0$01.&0*eni%, %$n0"%- &"%ns%in%ses


20/44


21/44

DIAGNOSISis0-%&i0n !i"#s '%"i #"ine %&%# s%-i!% 3 in44#

*e"&%% *0s& in!%si !i"#sC#-"e Vi"#s () > 3 %"i se&e-% in1#$%&i0nCPE $e"si5%& %s $e"#*% in-#si in&"% n#-e%",

in-#si *e"in#-e%" .%n4 e$es%"(se-9se-1i&0e4%-i/ 0+-6s e.e)

De&esi DNA *%'% #"ine '%n se"# 'en4%nen44#n%%n *0-.e"%se 1%in "e%1&i0n (PCR)CMV I4M .%n4 enin44i se"in4 en#n2#%n

in5esi %#& &e&%*i %"#s 'i0nf"%si 'en4%n

en44#n%%n !i"%- 1#-"eI4 G *0si&i5 .%n4 '%*%& 'i&"%ns5e" !i% *-%sen&%'%"i i$# e*%'% 2%ninTe"'%*%& I4 M %n&i$0'i, se"&% &e"'%*%& #-"

*0si&i5 *%'% #"ine '%n s%-i!%


22/44

(R'"('!(Se-5 -ii&in4 'ise%seP%'% %s#s .%n4 $e"%& Ganciclovir (

4/4 *e" '0se IV &i%* > 0#"s #n 93in44#),1ther reimens :F0s1%"ne& 'i&%$%%n 2i% &e"2%'i 4%n44#%n

5#n4si "en%-

Ci'050si"V%-4%n1i1-0!i"


23/44

>R'='!(1!

>ersonal protectiveH.4ieni1 *e"se0"%n4%nMen4in'%"i en1i# ne0n%s %&%# %n% 'e%&

*%'% #-#&Ti'% $e"4%n&i%n %-%&9%-%& %%n 'en4%n %n%9

%n%Seen&%"% en4in'%"i #$#n4%n in&i *%'%

*%s%n4%n .%n4 se'%n4 &e"in5esi

5lood products and oran donorsS"enin4 '%"% '%n 0"4%n '0n0" '%"i CMV

=accines


24/44

PARVO VIRUSMORFOLOGIVi"#s DNA sin4-e s&"%n'e'

F%i-i P%"!0!i"i'%eBen i0s%e'"%-

N0n en!e-0* !i"#s

EPIDEMIOLOGI MANIFESTASI


25/44

EPIDEMIOLOGI9MANIFESTASILINI

Vi"#s 'i&"%nsisi%n e-%-#i '0*-e& in5e1&i0nVi"#s *e"&%% %-i $e"e*-i%si 'i n%s05%"in4

e#'i%n s*"e'in4 !i"ei% 'i $0ne n%"""0+

Vi"#s ini ene*e- e".&"0i' *"e1#s0" se- 'i

s#s# -%n4 -i&i '%"i se- %nei% e$%&e#'i%n &e"2%'i # -ie sin'"0 0s&

%n&i$0'i i#ne 10*-ese#'i%n &e"2%'is*"e'in4 '%"i "%s .%n4 'i#-%i 'i *i*i (S-%**e'

1ee) es&"ei&%sIn5esi se-%% e%i-%n !i"#s ene$#s

*-%sen&% '%*%& &e"2%'i 'e5e1 *%'% 2%nin,i'"0*s 5e&%-is, '%*%& &e"2%'i e4#4#"%n


26/44

HERPES VIRUS


27/44

HERPES SIMPLE999

MORFOLOGIF%i-i e"*es!i"i'%e ( &04e&e" +i& !%"i1e--%

0s&e", E*s&ein9$%"" !i"#s, C.&0e4%-0!i"#s)

Vi"#s DNA

Me*#n.%i se-#$#n4

Ben i0s%e'"%- 'en4%n > 1%*s0e"


28/44

He"*es Si*-e %n' 9


29/44

Gi%n& 1e-- in'#1e' $.HSV


30/44

Ne0n%&%- He"*es Si*-eQ0# %"e 1%--e' &0 e9'%.90-' %-e $e1%#se &e n#"se10n1e"ne' &%& e is 2%#n'i1e': He +%s $0"n $. s*0n&%ne0#s!%4in%- 'e-i!e". &0 % >@9.e%"90-' 4"%!i'%>, *%"%> %5&e" %5#--9&e", #n10*-i1%&e' *"e4n%n1.: Te 0&e" %' n0 i--nes'#"in4 &e *"e4n%n1., se 'i' n0& #se &0$%110, %-100-, 0"'"#4s, %n' &e 0n-. e'i1%&i0n &%& se &00 +%s *"e n%&%-!i&%ins

:Se 'enie' %n. si4nif1%n& e'i1%- is&0". 05 4ene&i1

s.n'"0e 0" i--ness %0n4 1i-'"en: Te in5%n& i-'-. 2%#n'i1e'$#& %s % n0&%$-e %$n0"%--. s%-- e%' 1i"1#5e"en1e(i1"01e*%-.): His 1%"'i0!%s1#-%" e


44/44

#es&i0nJ%& &e 0s& -ie-. 1%#se 05 &is in5%n&6s 10n'i&i0n

H0+ 'i' e -ie-. %1#i"e &is

J%& is &e &es& 05 10i1e &0 10nf" &e 'i%4n0sis

Documents

TORCH Repro 2012