Kuman Jenis Morfologi Pewarnaan Sifat fisis& biokim Kultur Kx

PROTEUS Proteus mirabilis Proteus vulgaris Bacil Gram (-) Urease (+), PPA (+), H2S (+) Mc Conkey, EMB swarming character ISK, bedsores (decubitus)

MORGANELLA Morganella morganii

PROVIDENCIA Providencia rettgeri Providencia stuartii Gram (-) PPA (+)

CITROBACTER M. leprae Bacil Gram (-) Fer. Laktosa (-)

MYCOBACTERIUM

Gram (-) Urease (+), PPA (+)

Bacil, mikroskopis: globular masses ZN Media artificial (-), Armadillo, foot-pad-mice, jar.manusia Scraping kulit/ lesi (septum nasal, lobus telinga) Morbus Hansen, lesi kulit, gx neuro (anastesi) * Tipe Lepromatous: - progressive, malign, lesi kulit noduler (byk BTA) - gg saraf simetris - def. imun seluler - Facies leonine, Madurosa, Mutilasi * Tipe Tuberculoid: - Non progressive/ benign, lesi kulit macular (sdkit BTA) - gg saraf tdk simetris - imun seluler normal - Uji Lepromin (+) Sulfones, Rifampin, Clofazimine

ISK

ISK, nosokomial

Tx

Fx virulen

(R) Polymixin P. mirabilis (S) ampicilin P. vulgaris (S) cefotaxime Adhesin, endotoxin, motility

(S) Aminoglycoside, kloramfenikol

Kuman Morfologi Pewarnaan Sifat fisis & biokim Kultur

CORYNEBACTERIUM DIPHTERIAE Bacil, spora (-), pleimorfik, koloni : kecil, kelabu, granul Cub-shaped (ada granule metakromatik) Gram (+), Neisser (granule metakromatik) Aerob * BAP + K + tellurite: Koloni coklat-hitam * PAI (egg media) * Loeffler (media selektif) Dacron swabs dr tenggorok, hidung >> media transport Amies Pseudomembrane, Bull neck C. diphteriae tumbuh pada luka, kulit > menghasilkan eksotoxon > efek: necrotizing & neurotoxic > epitel rusak, inflamasi > nekrotik terperangkap fibrin+erit+leuko > Pseudomembrane Antibiotic, antitoxin, imunisasi DPT Exotoksin pd mukosa, sal. nafas >> efek: nekrosis & neurotoxic >> epitel rusak > nekrosis terperangkap fibrin + eksudat leu & eri >> Pseudomembrane (Tonsil, pharink, laring)

Dx Kx

Tx Fx virulen

MYCOBACTERIUM TUBERCULOSIS Bacil langsing, spora(-), koloni : kasar, putih-krem, bunga kol Dinding: lipid (wax, mycolic acid), protein Tuberculin, polisakarida ZN, Fluorochrome Obligat aerob Tahan malachite green & penicillin,, asam-basa,, kekeringan, Mati : sinar UV * LJ agar * Midd;ebrook (10,11), Middlebrook broth (9, 12) lebih cepat Amati pertumb : 6-8 mgg, doubling time : 18 jam (lama) Tuberculin Test Lesi Paru: 1. Tipe eksudatif : inflamasi akut, edema, lekosit PMN sekitar tubercle (tuberculin test +) 2. Tipe produktif : area makin besar > Tubercle caseous > cavity > sembuh berupa fibrosis /kalsifikasi Sulfonamide, Isoniazin, Rifampicin Kondisi hidrofobik dindng sel Clumped koloni Miiary TB : meningitis, renal, pleura

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