Post on 21-Feb-2018
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VARISELA DENGAN ANEMIADEFISIENSI BESI
Pembimbing :
dr. Sri Primawati Indraswari, Sp.KK
Oleh: Pandu Satya Widiarto (030.10.21!
Fa"u#ta$ %&do"t&ran 'ni&r$ita$ )ri$a"ti
SMF %u#it dan %a*in RS'D %ardina+ )&,a#- a/a )&n,a+
LAPRAN %AS'S
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PENDA'L'AN
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VARISELA
In&"$i a"ut ri*&r o#&+ iru$ari$a45o$t&r yan, *&ny&ran,
"u#it dan *u"o$a d&n,an ,&6a#a"on$titu$i dan "ainan "u#ito#i*or
D&7ni$i
Viru$ Vari$a45o$t&rEtio#o,i
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L&$i %u#it
Pau# &rit&*ato$a
V&$i" (Tear drop) Pu$tu# %ru$ta
G&6a#a rodro*a#
D&*a* Sa"it "&a#a
G&6a#a %#ini$
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)&r$&8ar "o$*oo#it = 9Biasa menyerang padaanak-anak
Eid&*io#o,i
Eid&*io#o,i
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:31 :12
;
Angka kejadian pasien dengan varisela di Sri Lanka (WHO, 2012)
INSIDENSI
Ai$arnt+anara" A- %i#,or& P- Poura+*ad M- A#*un&& MA. Infect Control Hosp Epidemiol200=- A$ia Pa? Pu8#i?&a#t+. 2010.Sri Lan"a @M? Gra/ i## @ 3>;4::
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RS'D %ardina+ %ota )&,a#
)a+un 201> 1: %a$u$ ari$a
)&r8anya" ada ana" &r&*uan u$ia 1141>ta+un
anuari4"to8&r 201: 10 "a$u$
)&r8anya" ada ana" &r&*uan
INSIDENSI
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%AS'S
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Na*a @ Ny. S.M
&ni$ %a*in @ P&r&*uan
'*ur @ 3: )a+un
A#a*at @ Banda$ari- du"u+ turi
A,a*a @ I$#a*
P&"&r6aan @ I8u Ru*a+ )an,,a
P&ndidi"an @ SMA
Statu$ P&rni"a+an @ M&ni"a+
Su"u Ban,$a @ a/a
IDENTITAS ASIEN
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Ana*n&$i$ %+u$u$(Ri/ayat P&nya"it S&"aran,!
Sa!"#, $0%Ok"%1&
(1 ari SMRS!
Pa$i&n *&n,u+
4 D&*a*- *ua#
4 Sa"it %&a#a
4 Badan #&*a$
4 )&rdaat,&*8un, "&?i#ada &rut danun,,un, $&8&$ar6aru* &ntu#
'ingg#, 1%Nv%1&
Pada a,i +ari
a$i&n *&n,u+$a"it "&a#a$&*a"in 8&rat-,&*8un, "&?i#8&ri$i air $&*a"in
8anya" dan*&ny&8ar "& #&+&r$&rta #&n,an dantun,"ai.
'ingg#, 1%Nv%
1&Pa$i&n di8a/a "& IGDRS'D %ardina+ u"u#21@00 WIB
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Ana*n&$i$ %+u$u$
Ri/ayat P&nya"itDa+u#u
Ri/ayat "u+an yan, $a*a (4!
Ri/ayat a#&r,i (4! Ri/ayat &n,,unaan o8at 6an,"a an6an,
(4!
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Ri/ayat P&nya"it %uar,a
Pa$i&n dan $ua*inya *&n,ata"an 8a+/aana"nya *&n,a#a*i "u+an yan, $a*a
$&&rti a$i&n t&at $&*in,,u $&8u*a$i&n *u#ai ti*8u# "u+an.
Ana*n&$i$ %+u$u$
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P&*&ri"$aan Fi$i"
%&$adaran @ o*o$ *&nti$ %&$an $a"it @ )a*a" $a"it $&dan,
%&adaan'*u*
)&"anan dara+ @ 110C0 **, Nadi @
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Statu$ G&n&ra#i$ Nor*o?&+a#i- ra*8ut +ita*- tida" *uda+ di?a8ut-
di$tri8u$i *&rata%&a#a o&d&* a#&8ra (4C4 !- "on6un,tia an&*i$ C-
$"#&ra i"t&ri" 4C4Mata
)ida" ada $&tu* d&ia$i- $&"r&t (4!idun, Siano$i$ (4!%ari&$ ,i,i (4!)on$i# )14)1 )&nan,-
Farin, tida" +i&r&*i$
Mu#ut Nor*otia - 8&n6o#an 4C4- ny&ri t&"an 4C4)in,a tot 8antu &rnaa$an M. St&rno?#&ido*a$toid&u$ (4!- tra"&a
di t&n,a+- d&ia$i tra"&a (4!- "&n6ar tiroid tida" t&ra8a*&*8&$ar- &*8&$aran %GB (4!L&+&r
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e)eriksaan *isik
T+raksINSESI B&ntu" nor*a#- ,&ra" naa$ $i*&tri$- t&rdaat "ainan "u#it
(#i+at $tatu$ d&r*ato#o,i"u$!
ALASI )ida" di#a"u"an &*&ri"$aan (8anya" t&rdaat &$i"!
E-.SI
)ida" di#a"u"an &*&ri"$aan (8anya" t&rdaat &$i"!
A.S.LTASI
Paru @ Suara naa$ &$i"u#&r di$uru+ #aan, aru "iri4"anan-ron"+i (4C4!- /heezing (4C4!
antun, @ Bunyi 6antun, I4II r&,u#&r- *ur*ur (4!- gallop(4!
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e)eriksaan *isik A!d)en
Datar- #&$i "u#it (!(#i+at $tatu$
d&r*ato#o,i"u$! +&ar
dan #i&n tida" t&ra8a*&*8&$ar- 8i$in, u$u$
(! nor*a#.
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Statu$ G&n&ra#i$
&d&* (4!- d&or*ita$ (4!-
"ainan "u#it (! (#i+at $tatu$d&r*ato#o,i"u$!- "ainan "u"u(4!
E"$tr&*ita$
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Statu$
D&r*ato#o,i"u$ G&n&ra#i$ataDi$tri8u$i
L&+&r- dada- &rut- un,,un,- #&n,an"anan dan "iri- tun,"ai "anan dan "iriAd r&,io
Mu#ti di$"r&t- 8&ntu" 8u#at- u"uran*i#iar4#&nti"u#ar- $ir"u*$"ri *&ni*8u#dari "u#itL&$i
Pau# &rito*atou$- &$i" (tear drop!d&n,an da$ar &rit&* (!- u$tu# (!-
Ero$i (!- "ru$ta (!
Eor&$&n$
i
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Statu$
d&r*ato#o,i"u$
*"1/ k#li" !agian le+er
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Statu$
d&r*ato#o,i"u$
*"2/ k#li" !agian lengan kanan*"$/ k#li" !agian lengan kiri
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Statu$
d&r*ato#o,i"u$
*"/k#li" !agian per#"
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Statu$
d&r*ato#o,i"u$
*"&/ 'rlgi k#li" !agian "#ngkai
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P&*&ri"$aan &nun6an,La8oratoriu*
Hematologi
Leukosit 5,4 ribu /mm35.000-10.000
Eritrosit 4,1 * juta/mm34,5-5,5b !,"* #/$l 1"-14
t "!,% * & 43-51
'rombosit "() ribu/mm3 150-400
LE+laju e$a $arah ! mm/jam 10
2 %3,)* emtoliter ("-!"
"",)* io#ram "%-31
31 #r/$l 3"-3%
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P&*&ri"$aan &nun6an,La8oratoriu*
Kimia
67O' 4%,! * u/l 35
67' "1,! u/l 41
R
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R&$u*&
S&oran, &r&*uan 8&ru$ia 3: ta+un &"&r6aan i8u ru*a+ tan,,adira/at di 8an,$a# La&nd&r RS'D %ardina+ d&n,an "u+an a/a# ny&ri
"&a#a dan d&*a* yan, di$&rtai d&n,an *un?u#nya ,&*8un, 8&ri$i?airan $&6a" 1 +ari $&8u* *a$u" ru*a+ $a"it- ,&*8un, 8&ri$i ?airant&ra$a ana$ di &rut.
Pada ana*n&$i$
4 G&*8un, 8&ri$i ?airan-
4 M&ny&8ar dari *u#ai &rut L&n,an dan %a"i
4 Sa*a &ra/atan 8&8&raa ,&*8un, &?a+ dan ?airan *&n6adi"&rin, 8&r/arna ?"#at "&+ita*an.
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R&$u*&Pada &*&ri"$aan 7$i"
4 "on6un,tia an&*i$
4 &$i" yan, 8&r8&ntu" 8u#at (Tear drop) u"uran *i#iar4#&nti"u#ar 8&r8ata$ t&,a$ yan, t&r$&8ar di #&+&r- &rut- un,,un,#&n,an dan tun,"ai "anan4"iri (r&,iona#! d&n,an &or&$&n$i au#
&rit&*ato$a- &$i" (Tear drop! u$tu# dan "ru$ta.
P&*&ri"$aan &nun6an, #a8oratoriu*
8 ;-2 ,Cd# (di8a/a+ nor*a#!
Eritro$it >-1 6utaC**3(di8a/a+ nor*a#!
t 2;-< (di8a/a+ nor*a#!
MV
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1. Vari$a d&n,an
an&*ia d&. 8&$i
2. Vario#a An&*ia
d&7$i&n$i 8&$i
3. &r&$ Ho$t&r d&n,an an&*iad&. 8&$i
Dia,no$i$ Bandin,
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DIAGNSIS %ERA
Vari$a d&n,anan&*ia d&7$i&n$i
8&$i
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'S'LAN
PEMERI%SAAN
1. Tzanck smear testd&n,an &/arnaan
Gi&*$a2. P&/arnaan ram
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P&nata#a"$anaan
ena"alaksanaan k+#s#s
()edika)en"sa!
ena"alaksaan .)#)
PENA)ALA%SANAAN
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P&nata#a"$anaan '*u*
Ra/at inaEdu"a$i a$i&n
*&n,&nai &nya"itnya
Monitorin, "&adaanu*u*- tanda ita#
Motia$i
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P&nata#a"$anaan
%+u$u$ !"sidic #cid $% zalf
(dio#&$ ada
,&*8un, yan,ta+ &?a+ dan#u"a di"u#it 2 "a#i$&+ari!
)oi"a#
IVFD- RL >0 t* A$i"#oir :00 *, (&r4
ora#!
Para?&ta*o# 3:00 *,(&r4ora#! A*oi?i##in 3:00 *,
(&r4ora#! &tiri5in& 110 *, (&r4
ora#!
)ran$u$i PR :00??
Si$t&*i
"
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Pro,no$i$
Ad 8ona*uo ad ita*
Ad 8ona*uo adun,$iona*
Ad 8ona*uo ad
$antiona*
Ad 8ona*uo ad
"o$*&ti"u*
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PEMBAASAN
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Ana*n&$i$
P&*&ri"$aanFi$i"
VARISELA
G&6a#a rodro*a#-ri/ayat "onta" d&n,an
oran, "u+an yan,$a*a
Statu$ ,&n&ra#i$ dan
$tatu$ d&r*ato#o,i"u$
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/anita8&ru$ia
3: ta+un
G&6a#aProdro*
a#
Fa$&&ru$i"u#it
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PERBEDAAN %LINIS
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IS)PA)LGI
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P&nata#a"$anaan
Si$t&*i"
Anti iru$
Si*to*ati"
)oi"a#
M&*8antut&rai
$i$t&*i"
Antiina*a$i
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Aa8i#a "ita 8&rtinda" ?&at dan t&at-*a"a ro,no$i$ ?u"u *&*ua$"an
Pro,no$i$
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)ERIMA%ASI