Vaccinated Diseases - Nathania S.

/07120100071

Disease

Etiology

Unique S&S

Brief Patophysiology

Diagnostic

Treatment / Plan

- survive in the acidic environment

of gaster
- pass to the wall and contact with
phagocytic cells in Peyers Patch
(M cells)
- ruffled enterocyte cell membrane
& cytoskeletal adhesion
- bacteria endocytosed
- B exit the basilar aspect in the cell
and free in lamina propra
- phagocyted in Peyers Patch
- Hematogenous & lymphatic
dissemination -> LIVER &
SPLEEN & BONE MARROW

- blood culture
using GALL
culture (GOLD)
- Widal test

1st : chloramphenicol,
ceftriaxone
2nd : ampicillin and/or
ciprofloxacin (adult)

TIMING :
w1 : blood
w2 : urine, feces
w3 : feces,
auscultation
(perforation?)

Penicillin allergic : TMP/

SMX (child),
chloramphenicol (adult)

- VIRULANCE FACTOR :
1. Bacteria : invasion, proliferation
in the local tissue
2. Toxin : necrosis
- can affect tonsil, pharynx, nasal
cavity, pharingeal & tonsilar,
laryngeal, cutaneous, genital

Clinical

- antitoxin (IM or IV)

- antibiotic : PenG (IM)
- oxygen & tracheostomy if
indicated
- supportive therapy

Others

TYPHOID VACCINE
TYPHOID
FEVER

Salmonela
thyposa
- Gr. (-)

- diarrhea continued by
constipation
- continous fever,
exacerbated at night
- roseola (rare among
Indonesians)
- delirium
- paroxysmal
bradycardia

DPT (IM)
- DTwP - whole cell
- DTaP - acellular components
DIPHTERIAE

Corrynebacter - pseudomembrane
ium diphteriae - bullneck appearance
Gr. (+)

Pelayanan
Kesehatan
Anak di
Rumah
Sakit.pdf Kemenkes

Vaccinated Diseases - Nathania S. /07120100071

Disease
TETANUS

Etiology

Unique S&S

Clostridium
tetani
Gr. (+)

- trismus (lock jaw)

- risus sardonicus
- ophistotonus
(melengkung)

Port dentry : WOUND, ingested

TOXIN :
- tetanospasmin : blocks
transmission of inhibiting neurons
- tetanolisin : necrotizing cells

- rigidity and spasm

- irritability
- unable to be breastfed

born from non-immunized mother or

unsterilized equipment during labor
(esp. when the cutting of umbilical
cord)

Plan a good ANC to prevent

and good and sterile
delivery process

- whooping cough
- 100 days of cough
- tussis quinta

- bacteria : attached in respiratory

Clinical
cillia, inflammation cause inhibition
of sputum clearance and
pulmonary secretion
- toxin

- Antibiotic : erythromycin
(oral)
- Oxygen
- Airway management
- DO NOT GIVE antitussive,
sedative, mucolytic and
antihistamine

Tetanus
neonatorum

PERTUSSIS

Bordetella
persussis
Gr. (-)

Brief Patophysiology

Diagnostic
Clinical

STAGES :
- catarrahal (2w) - CONTAGIOUS
- paroxysmal / spasmodic
- centravalence

Treatment / Plan
- antibiotic Penicillin OR
Tetracyclin (CI : child)
- antitetanus serum
- diazepam
- wound healing protocol

MMR - IM
MUMPS
(Gondongan)

Mumps virus

- painful swelling on the

salivary glands,
unilateral

MoT : droplet & saliva

The virus invade and replicate
within the cell in salivary gland

Clinical

self limiting disease

Others

Vaccinated Diseases - Nathania S. /07120100071

Disease
MEASLES
(Campak) /
Rubeolla /
Morbili

Etiology
Morbili virus

Unique S&S

Brief Patophysiology

Diagnostic

Treatment / Plan

3C :
- coryza
- conjunctivitis
- copliks spot (the truth
is ...KOPLIKs spot)

MoT : respiratory droplet & direct

contact
- adhesion & invasion of respiratory
epithelium

Clinical

- vitamin A : to protect
mucosa & re-epithelization

Respiratory transmission of the

virus, replication in the
nasopharynx and regional lymph
nodes, transplacental

Clinical

self limiting disease

From head to toe spread

- macula -> papula ->
desquamation
RUBELLA
(Campak
Jerman)

Rubella virus

Congenital
Rubella

- exanthem rash
(maculopapular)
- lymphadenopathy
- abrupt onset
TRIAD :
- microcephaly
- PDA
- catarract

can be prevented!

- blueberry muffin lesion

- ichteric
- IUGR
VARICELLA
Varicella (Cacar Varicella
air)
zoster virus

- vesicopustular
- centrifugal spread

Little known about this disease.

Clinical

acyclovir on high risk

patients (AIDS, pregnant
woman, >12 yo)

Others

Vaccinated Diseases - Nathania S. /07120100071

Disease

Etiology

Unique S&S

Brief Patophysiology

Diagnostic

Treatment / Plan

Others

POLIO
Poliomyelitis

TORCH

Polio virus

type : asymptomatic,
MoT : oral-oral or fecal-oral
without any disease,
- replicated in the pharynx and
abortive p., non-paralytic lower GI tract.
p., paralytic p.
- spread to the regional lymph node
- affecting the cornu anterior
- biphasic paralytic and
medula spinalis, vermis medularis
sudden onset
cerebelum, midbrain, thalamus,
- assymetrical paralysis
hypothalamus, paladium, motoric
or paresis
cerebrum cortex
- bladder paralysis or
- in the medulla, causing paralysis
atoni of GI tract
- spacicity, stiff neck
(kaku kuduk),
hypothonus and
sensory abnormality

- stool
examination for
polio virus
(WHO)
- CSF
examination
- serologic

neutralizing antibody (1
week after infection)

slide dr.
dina!

Vaccinated Diseases - Nathania S. /07120100071

Disease

Etiology

Unique S&S

Toxoplasma

Toxoplasma
gondii

MATERNAL
- asymptomatic
- lymphadenopathy
- visual changes
BABY
- chorioentinitis
- hydocephalus or
microcephaly
- cerebral calcification

Brief Patophysiology

Diagnostic

Treatment / Plan

definitive host : your beloved cat

- tachyzoit : IgA response
- spread from GI tract to multiple
organs (lymphatic, striated
muscle, myocardium, retina,
placenta and CNS
- destruction of tachyzoid
manifested in MOF (necrotizing
encephalitis, pneumonia and
myocarditis)
- bradyzoit : clinical manifestation

PCR DNA, USG

Serology :
- IgG (1-2 w) peak
at 1-2 month
(positive for
lifetime)
- IgM : 10 days
after infection

**routine prevention is not

recommended except in
HIV
MATERNAL :
- spiramycin
FETUS :
- pyrimethamine
- sulfonamide
- folinic acid (prevent NTD)

Rubella

Already described

CMV

Cytomegalovi
rus

unknown prematurity
and fetal death
- asymptomatic to
infectious
mononucleosis

MoT : nasopharynx droplet, urine,

saliva, semen, cervix, vertical and
breast milk

Clinical

- symptomatic management
- ganciclovir (cat : C)

Herpes

HSV

- painful vesicles

Mot : intrauterine, peripartum, post

natal

Clinical

Management of delivery :
- no lesion : vaginal
- lesion : sectio caesarea

Trimester 1 : abortus
Trimester 2 : prematutiry

Others

Read by yourself

affecting nervous system to the

axon

Antivirus :
- acyclovir, valcyclovir,
famcyclovir

Others

Vaccinated Diseases - Nathania S. /07120100071

Disease

Etiology

Unique S&S

Brief Patophysiology

Diagnostic

Prodromal :
- pruritus and
paresthesia in the biten
site
- paralytic
- myoedema (mounding
part)

virus from wild dog -> muscle ->

replicating and go to the peripheral
nervous terminal.

Clinical, post
mortem biopsy :
NEGRI BODIES.

centripetal spread to the CNS, then

to ANS, skeletal muscle,
myocardium, adrenal gland, kidney,
eye and pancreas.

EEG : slow wave

with paroxysmal
spike

Treatment / Plan

RABIES
Vaccines :
- Nerve tissue vaccine (NTV)
- Non-nerve tissue vaccine
Rabies

Rabies virus

Acute neurology st. :

- furious (hyperactive,
disoriented,
hallucinating), agitated,
etc. intermitten every
1-5 mins
- paralytic
- hydrophobia
- aerophobia
- photophobia
ANTHRAX (IM)
Anthrax Vaccine Adsorbed (AVA)

virus existed in salivary gland,

lacrimal gland and resp. system;
breast milk and urine.
complication : raised ICP, diabetes
insipidus, SIADH.

- neutralizing antibody
(vaccine)

Others

Vaccinated Diseases - Nathania S. /07120100071

Disease
Anthrax /
Woolsorters
disease /
Siberian ulcer /
charbon /
ragsorters
disease

Etiology
Bacillus
anthraxis
Gr. (+) with
spore

Unique S&S

Brief Patophysiology

- Cutaneous : papule
lession and itchy, black
carbuncle appearance,
kalor, rubor, non-pitting
edema, local
lymphadenopathy
- Inhalation : phase 1 not specific, phase 2 high fever, hypoxia,
stridor, cyanosis. NOT
PNEUMONIA
- Ingestion : diffused
abdominal pain,
hematemesis and
melena, messenteric
lymphadenitis, ascites,
perforated intestine.

VIRULANCE FACTOR :
PA (protective antigen), EF (edema
factor), LF (lethal factor)
cutaneous :
port dentry : wound
secreting exotoxin and
antiphagocytic material capsule,
lymphatogenous, lymphadenitis
inhaled :
spore in the alveoli, phagocyted by
macrophage, spread to the
mediastinal lymph node,
germination causing hemorrhagic
and lymphadenitic in mediastinum
ingested : pharynx swelling,
tracheal obstruction, cervical
lymphadenopathy, necrosis and
hemorrhage of intestinal mucosa,
ascites and sepsis

TRAVELLERS DIARRHEA

Diagnostic
Clinical

Treatment / Plan
- Pennicilin G.
Alternative :
tetracyclin,
chloramphenicol,
erythromycin

Others

Vaccinated Diseases - Nathania S. /07120100071

Disease

Etiology

E. Coli - ETEC

E. coli
(enterotoxi
genic)

Unique S&S
diarrhea ... and other
non specific symptoms

Gr. (-)

Giardiasis

Read on your gastro book!

Shigella

Read on your gastro book!

Brief Patophysiology

Diagnostic

- fimbrial adhesins of the bacteria

bind enterocyte cells in small
intestine
- toxins :
LT - similar to cholera toxin
ST - causes cGMP accumulation
and stimulate to secrete fluid and
electrolytes into the intestinal
lumen

Stool examination
for polio virus
(WHO)
CSF examination
serologic

Treatment / Plan
prevention : safe food &
drink!
Antibiotic : amoxicillin
(beware of the resistance)

Others