Bahan Infeksi TORCH

7/25/2019 Bahan Infeksi TORCH

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DETEKSI INFEKSI DENGAN

IMUNOSEROLOGI

STEFANUS LEMBAR

BLOK KONSEP PATOLOGI 3

21 DESEMBER 2013



PENDAHULUAN

Kultur mikroorg!i"m# m"i$

m#ru%k! gol& "t!&r& u!tuk

&ig!o"tik %#!'kit i!(#k"i1)*0 &! 1)+0! &ik#m,!gk! t#k!ik

"#rologi -Ou&i! &! Ou.$t#rlo!'/

Ko!"#% imu!ologi -(ik""i kom%l#m#!RIA EIA &ll/



PENDAHULUAN

R#"%o!" imu! &im#&i"i !ti,o&i '!g

&i"#kr#"ik! ol#$ "#l lim(o"it B

P#!g#!l! !tig#! "#.r "%#"i(ik"u&$ &imiliki "#k l$ir "m%i

"#lm $i&u%!'



PENDAHULUAN

r k#r !ti,o&iM#l#kt %& %#rmuk! %tog#! gr

l#,i$ &%t &it#rim ol#$ (go"it-o%"o!i""i/

B#rikt! &! m#!g$l!gi r#"#%tor

%#rmuk! %& "#l $o"%#" -!#trli""i/

M#l#kt %& %#rmuk! %tog#! &!

,#r%#r! &lm m#!g$!.urk! 4i "i"t#m

kom%l#m#! -(ik""i kom%l#m#!/



RESPONS IMUN

BAGAIMANA APLIKASI KLINIK

PEMERIKSAAN RESPONS IMUN UTK

DIAGNOSTIK INFEKSI????

BAGAIMANA IgM DAN IgG

DIBEDAKAN?



[TOKSOPLASMA, RUBELA, CITOMEGALOVIRUS

AN HERPES 1,2]

TORCH



ETIOLOGI

To6o%l"m go!&ii o,ligt# i!tr.#llul#r

%roto7o "%oro7o8

9iru" Ru,#ll (mili Tog4iru"89iru" 'tom#glo4iru" (mili :#r%#" 9iru"8

9iru" :#r%#" Sim%l#6 (mili :#r%#" 9iru" :S9 ti%# 1 m#!'#,,k! i!(#k"i %& tu,u$

,gi! t" "#%#rti gi!ggi4o"tomtiti" (ri!giti"k#rtoko!u!gti4iti" &! #!"#(liti"8

:S9 ti%# 2 m#!'#,,k! $#r%#" g#!itli"8



GEJALA KLINIK

1/ DE;ASA A"im%tomtik tu i!(#k"i ri!g!

&#mm %#m,#"r! KGB #rit#m %& kulit

-ru,#ll/ $#%titi" -M9/8

2/ ;ANITA :AMIL i!(#k"i i!trut#ri! -k#gugur!

l$ir mti ..t ,5! i!(#k"i ko!g#!itl/8



DIAGNOSIS

18 KULTUR i"ol"i %roto7o < 4iru" &lm

&r$ &! .ir! tu,u$ li!8

28 SEROLOGI tit#r !ti,o&i &lm "#rum8



PEMERIKSAAN SEROLOGI (2)

A&!' !ti,o&i t#r$&% mikroorg!i"m# t#rt#!tu

m#!u!ukk! "#"#or!g "#&!g i!(#k"i %#r!$

t#ri!(#k"i tu %#r!$ &i4k"i!"i &#!g!mikroorg!i"m# t#r"#,ut8

P& i!(#k"i kro!ik ui "#rologi tu!ggl u!tuk

m#!#!tuk! !ti,o&i &%t &i%ki u!tuk m#!u!!g

&ig!o"i"8 S#&!gk! %& i!(#k"i kut &i%#rluk! ui

g!& &#!g! !gk 5ktu 1* = 21 $ri8



PEMERIKSAAN ANTIBODI

TORCH ( Ig M aa! Ig G ) (")

I!(#k"i i!trut#ri! m#!'#,,k! !i! m#m,#!tuk

IgM "%#"i(ik "#$i!gg &!' IgM "%#"i(ik &i &lm

&r$ ,'i m#!u!ukk! i!(#k"i ko!g#!itl8

IgG "%#"i(ik ,ru t#r,#!tuk "#g#r "#t#l$ l$irIgG t#r"#,ut "ukr &i,#&k! &ri IgG "%#"i(ik '!g

,#r"l &ri i,u8

Ol#$ kr#! IgG "%#"i(ik '!g ,#r"l &ri i,um#m%u!'i 5ktu %ru$ kir = kir 1 ,ul! mk

&!' IgG "%#"i(ik &i &lm &r$ ,'i '!g

k&r!' m#!#t% "#lm 2 = 3 ,ul! tu

m#!i!gkt m#!u!ukk! i!(#k"i ko!g#!itl8



INDIKASI PEMERIKSAAN

ANTIBODI TERHADAP TORCH

1/ P& 5!it $mil u!tuk m#!#!tuk! i!(#k"i

kut

) S#roko!4#r"i &ri ->/ m#!&i -@/

) K#!ik! tit#r IgG "#,!'k * kli tu l#,i$

) IgM -@/

2/ P& ,'i u!tuk m#!#!tuk! i!(#k"i ko!g#!itl

) Tit#r IgG m#!#t% tu m#!i!gkt) IgM -@/

3/ U!tuk m#!#!tuk! "ttu" k#k#,l! &!

k#,#r$"il! imu!i""i -Ru,#ll/8



RUBELLA

P#m#rik"! !ti,o&i t#r$&% Ru,#ll -IgG

&! tu IgM/8

IgM tim,ul %& "t tim,ul!' g#lm#!.%i %u!.k &lm 5ktu 10 $ri &!

k#mu&i! m#!g$il!g "#t#l$ +0 $ri8

IgG tim,ul 1 mi!ggu "#t#l$ tim,ul!' g#l

m#!.%i %u!.k &lm 5ktu 1 = 2 mi!ggu &!

k! m#!#t% "m%i ,#,#r% t$u!8



AIDS

( AC&UIRED IMMUNODEFFICIENC$

S$NDROME ) A&l$ kum%ul! g#l '!g &i"#,,k! ol#$

i!(#k"i 4iru" :I9 '!g m#ru"k T $#l%#r .#ll" -"#l T

%#!olo!g/8 Dik#!l 2 ti%# :I9 'itu :I9 1 &! :I9

28 K#&u!' m#m%u!'i "truktur '!g miri% "tu

"m li!8

Struktur i!i t#r&iri &ri .or# -i!ti/ &! #!4#lo%#

-"#lu,u!g/8 P& i!&i4i&u '!g t#ri!(#k"i :I9 !ti>.or# tim,ul t#rl#,i$ &$ulu &iikuti &#!g!

tim,ul!' !ti>#!4#lo%#8 B#,#r% %rot#i! .or#

&! #!4#lo%# i!i &i&ik! %#g!g! &lm

&ig!o"i" l,ortorium8



PEMERIKSAAN LABORATORIUM (1)

U!tuk %#m#rik"! %#!'ri!g &ilkuk! t#" Eli"u!tuk m#!&#t#k"i !ti :I98 A!ti :I9 %o"iti( %&

or!g '!g "#$t "#.r kli!i" &%t ,#rrti

I!(#k"i :I9 "u,kli!i"

rri#r

Po"iti( %l"u

U!tuk ko!(irm"i &ilkuk! %#m#rik"! !ti :I9

.r ;#"t#r! Blotti!g8 D#!g! .r i!i &%t&ili$t &!' !ti %2* tu%u! !ti g%*1 &ll8

U!tuk &ig!o"i" %"ti &i.ri &!' 4iru" &lm

&r$8



PEMERIKSAAN LABORATORIUM (2)

P& %#!&#rit "#ro%o"iti( %#rlu &ilkuk!

%#m!tu! t#ru" kr#! g#l ,ru tim,ul

"#t#l$ ,#,#r% t$u! "#$i!gg or!g i!i &%tm#!&i "um,#r %#!ulr!8

P& (ull,lo5! AIDS "#ri!g t#r&i i!(#k"i

o%ortu!i"tik &! k#g!"! "#$i!gg

%#m#rik"! l,ortorium ug %#rlu &ir$k!u!tuk m#!.ri &!' i!(#k"i &! k#g!"!

t#r"#,ut8



DEMAM TIFOID



PATOGENESIS

Bik %& t'%$oi& mu%u! %& #!t#ri. (#4#r

i!(#k"i muli t#r&i %& u"u" $lu" &#!g!

g#l g"troi!t#"ti!l '!g mi!iml8 Org!i"m#t#r"#,ut m"uk &! m#m%#r,!'k &iri &lm

mkro(g &i %lu# P#'#ri k#mu&i! m#!'#,r

k# $ti k!&u!g #m%#&u &! lim%8 S#t#l$ itu

k! t#r&i ,kt#ri#mi &i"#rti &#mm &!g#l li!!' k#mu!gki!! &i"#,,k! ol#$

#!&otok"i!8



GAMBARAN KLINIS

G#l %#rtm ,i"!' &#mm &!ko!"ti%"i8 S#t#l$ 1 mi!ggu &#!g!

&!' ,kt#ri#mi tim,ul &#mm

ti!ggi "kit k#%l "%l#!om#gli &!

l#uko%#!i8



MANIFESTASI IMUNOLOGIK (2)

B#r,gi (ktor m#m%#!gru$i m!i(#"t"i

i!i "#$i!gg m#m%#r"ulit $"il t#" "#rologi8

Fktor = (ktor i!i !tr li! St&ium %#!'kit

Tit#r ,"i" '!g ti!ggi &i &#r$ #!&#mik

tu kr#! 4k"i!"i

R#k"i "il!g

P#!go,t! &#!g! !ti,iotik "#,#lum

%#m#rik"! &ilkuk!



DIAGNOSIS LABORATORIUM (2)

K#!ik! tit#r 7t !ti "#,#"r * kli tu

l#,i$ m#m,#rik! i!&ik"i &!' &#mm

t'%$oi&8 S#li! itu ,il tit#r !ti O l#,i$

,#"r &ri 1<1?0 ug m#!'oko!g &!'

i!(#k"i Slmo!#ll t#t%i %#rlu &i%#r$tik!

(ktor = (ktor '!g t&i t#l$ &i"#,utk!8K#!ik! tit#r !ti O l#,i$ ,#rmk! &ri

!ti : kr#! %& 4k"i!"i tit#r !ti : i!i

m#!i!gkt8



SEPSIS

o Norml ti&k & mikroorg!i"m# &i &lmlir! &r$8 Klu & mikroorg!i"m#

%#!'#,, &ik#!l &!' 4ir#mi ,kt#ri#mi

(u!g#mi &! %r"it#mi8

) S#%"i" tu "#%tik#mi &l$ i"til$ '!g

m#!ggm,rk! g#l kli!i" ki,t #!&otok"i!

'!g &ik#lurk! ol#$ ,kt#ri8 K#&! i!i

&%t &i"#rti tu t!% &i"#rti &!',kt#ri &lm "irkul"i &r$ -,kt#ri#mi/8

) P& "#%"i" &ium%i &!' &#mm

m#!ggigil $i%ot#!"i $i%ot#rmi &! r#!t!8



DIAGNOSIS

Dig!o"i" "#%"i" &ilkuk! ,#r&"rk! g#l

kli!i" "#rt %#m#rik"! l,ortorik8 U!tuk

m#!.ri ,kt#ri %#!'#,, "#%"i" &ilkuk!

,ik! &r$ 5lu%u! %#rlu &ii!gt ,$5ti&k "#mu "#%"i" &i"#rti ,kt#ri#mi8



DENGUE HEMORRHAGIC

FEVER

D:F m#ru%k! %#!'kit m#!ulr '!g

&i"#,,k! ol#$ i!(#k"i 4iru" -Art$ro%o&#

Bor!# 9iru"/8 P#!ulr! t#r&i m#llui

gigit! !'muk A#&#" #g'%ti tu A#&#"l,o%i.tu"8



GAMBARAN SEROLOGIK

9ir#mi tu &!' 4iru" &lm lir! &r$

k! ,#rl!g"u!g "#lm 1 mi!ggu8 P& 5l

%#!'kit k! &i,#!tuk IgM !ti D#!gu# t#t%i$!' u!tuk 5ktu "i!gkt8 S#l!ut!' k!

&i,#!tuk IgG8 A!ti,o&i t#r$&% D#!gu# &%t

&i&#t#k"i &#!g! ,#r,gi .r

N#utrli7tio! t#"t T#" $m,t! gluti!"i

om%l#m#!t (i6tio! t#"t



DIAGNOSIS LABORATORIUM

Dig!o"i" l,ortorium &ituuk! u!tuk m#!&#t#k"i

!ti,o&i "%#"i(ik -%#m#rik"! "#rologi"/ &! u!tuk

m#!gi"ol"i 4iru" "#rt m#!gi&#!ti(ik"i 4iru"8

P#m#rik"! "#rologi" '!g %li!g &%t

&i%#r.' &l$ ui !#trli""i8 Ui i!i &%t

&ilkuk! "#.r i!4i4o m#!ggu!k! "u.kli!g

mi.# tu "#.r i!4i4o &#!g! ,ik! ri!g!8 Ak$ir = k$ir i!i t#l$ &ik#m,!gk! t#" Eli" '!g

&%t m#!&#t#k"i IgM !ti D#!gu# mu%u! IgG

!ti D#!gu#8



I*!-.g/.0!/- a-g 0''a-

3a/a* '+.-+ *!- 'a4+ *'

a3a/a,518 Ig G

28 Ig A

38 Ig M

*8 Ig D

+8 Ig E



S'.4.-9'+ !-!4 IgG a3a -7'4+

TORCH a3a/a, 4'-a4a- IgG ::# 3a

' IgG +'*!/a;

18 2

28 3

38 *

*8 +

+8 ?



M'.3' '*'4+aa- a-g

0'!8!a- !-!4 4.-7*a+ ,a+/

a- HIV18 #li"

28 5#"t#r! ,lotti!g

38 S$out#! ,otti!g

*8 i"ol"i 4iru"

+8 PR



Dag-.++ a+ 3'*a* ,.3

a3a/a,5

18 5i&l

28 kultur "lmo!#ll

38 Ig M "lmo!#ll

*8 kogul"i

+8 !#trli""i



P'-'0a0 !a*a 3'*a* ,.3

18 S$ig#ll "%

28 Kl#,"i#ll "%

38 P!#umokoku"

*8 Slmo!#ll "%

+8 A.i!#to,.t#r "%



$a-g 0!4a- *'!a4a-

-''a+ a-g 0'-a ',a3a

,a+/ a- HIV < a3a/a,5

18 Kri#r

28 Po"iti( %l"u

38 I!(#k"i "u,kli!i"

*8 I!&#t#rmi!t#

+8 M#miliki k#k#,l!



I*!-.g/.0!/- a-g *'*/4

*a4-a 4/-4 +'=aa !g'-+a+

a3a DHF a3a/a,518 Ig G

28 Ig A

38 Ig M

*8 Ig D

+8 Ig E



I*!-.g/.0!/- a-g *'*/4

*a4-a 4/-4 a3a -7'4+ TORCH

a3a/a,5

18 Ig G

28 Ig A

38 Ig M

*8 Ig D

+8 Ig E



JA>ABAN

*38 3 *8 2

**8 3 *)8 *

*+8 * +08 +

*?8 3 +18 1

*C8 2 +28 3

Bahan Infeksi TORCH

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