Tropical Medicine

"
"

UKDI -
CORNER
 Dengue fever ( Dengue Hemorragic Fever
↳ etio : Dengue ( DEN I DENZ
Virus , .
DEN 3 . DEN 47

Vettori Hyam UK Aedes Agepty

.

Kunis lebih Berat

DF DH f
# lnteksisekunder
Kuda)
'

Kunis lebih Rangan -

Demain t 3ham WI (Demain pelana

lhfeksi Primer Nyeri Badan Nyeri Hoysala

-

( Pertama) -

mud muntah

Manifestasi Perdarahan (ptekle , Mimi San , BAB hitam )

- Kebocoran plasma C-I kebocoran plasma Ct )
Ht 't s 10% -

Htt 7202
Ht 4453 Ht 7452
efusi pleura ,
Ascites edema GI
,

-
Trombosit 2150.000 -
Trombostt L 100.000,19Gt)
Rumple leedctllperdarahan
{
khat DHF art : talk Spartan
perdarahan "
"

II : Perdarahan spontancptekie ,
mimisan )

{ syok TeruKur ( TDI

Ghat vs ! " "

III : .
HRT ,
tkesadaran)

N
SYOK Tdk Teru Kur (TD Tdk Teru Kur
" "
:

Nadi Tdk Taraba tkesadaran! ,

DSS ( Dengue syok Sandro me )

'
-

DHF 9r HI /9rI

P penuryang
. : -
awal : Daran Ruth ( Ht Trombostt )
,

Antigen :
NS I -
( Hi -
Hs )
-
AntiBodi :
IgM Anti Dengue ( Hy Ha ) -

IgG Anti Dengue ( Hg tho ) -

.
Bertahan BerBulan ?
-

Th :
DF ( Rawat Jalan , Bykminum ,
obat symptomatic ) ,
DHFCR Hap Rehidrasi RLINACI )
-

}¥
DHF gr I e II : NFP NaCl 0.9% 7 41KGBP41 am

"""
DHF
DHF
gr

9r
HI
II :
: I VFD
NFD
NaCl
NaCl 0.92
10 -
9% to -20

go cc
cc/kgBB/j am
BB Bolo , go Ismene ,
-
!
Check point ! !
 Malaria
↳ etio : Plasmodium
Vettori Nyamuk Anopheles
Dx :
Trias malaria t FR Ct ) Bepergian ke daerah endemics

i. men 991911 Cth : Nias ,

Flores ,
NTT ,
NTB
2.
Demain Papua
3 Berkeringat
-
Klas IttKasi
•
Malaria Tampa Kompukasi Celio :
Senna genis plasmodium ) → obat Oral

Malaria Berat Ceto P Falciparum) Artesun at Arth@meter

'

obat
Ing:
•
: . →

Malaria Berat
-

Malaria t t kesadaran :
M .
Serebrat

-
Malaria 1-
syok ( Tbd HRT tkesadaran ) : M -
Algid
-

Malaria t BAIT hitam ( Hemoglobinuna) : Black Water Fever

P .

penuryang :
-

SADT Csediaan Apusan

He
daran Tepi)
Tebal/Tp
Plasmodium
v

Alembedakan
Jen is
-

Rapid Test Malaria

1 .
Plasmodium falciparum ( M -

falciparum / M -
Tro pirana )
-
Pola Demain tdkmenenlv
-
entreat talk membesar
-

Tanda Khas : Maurer dots ( seperti Taburan bintang

di langit )
-

Trofotolt :
Ring form Accole ,

Headphone
-
Gametosit :
Bulan Sabat ,

Bennie Crescent ,
Banana shaped t Pisans
sausage shaped
2 . P vivax ( M
.
.
vivax / M Tertiana ) .

Pola Demain l - 2 - I -
2 :
Tropicana
-
entreat me mbesar
Tanda Khasi Schoener
" "
- .
dots

Trofozoit :
Ring form Amoeboid .

- Gametosit Bentuk Sferis

:

3 . P Ovale ( M
. -
ovale / M Tertiana)
.

-
Pola Demain I -
2 -
l -
2 :
Tropicana
-

entrees it membesar ( ovale ,

fimbriae Ct )
"
"
comet shaped
-
Tanda Khas :
Schoener dots

James dots
-
Gameto sit : Bentuk stems

4 . P .

malaria e ( M Malariae ( .
M kuartana)
.

Pola Demain l -
3 -
I -3

-
en troat talk membesar
-
Tanda Khas Zieman : dots
-
Trofozoit Pita ( Band
:
Form ) ,

Rectangular shaped
Esg
"
Basket form "

Skizon :
Bunga / Rosette
-
Tith Kesar , Besar .
Gelap
Th :

P .
falciparum :
ACT 3hr t
prima Kun
ihr

p . Vivax ( ovale :
ACT 3h r t
prima twin 14 hr ( 4 Bunch Std Hlpnozoit )
P Malaria
.
:
ACT 3hr

Ibu Hamil :
ACT 3hr

ACT ( Artemisinin Combination Therapy ) = Arlesunat t Amodiakuin

atau

Dogs ACT Does Primakov's Dlhidroartemisinin Plperakuin

BBC 60kg : 1×3 Tab BBC 60kg : H2 Tab ( DHP )
760kg : 1×4 Tab BB 760kg : 1×3 Tab

Profkaksis Malaria
-

Hlndari glgitan Myamok ( Kelambu ,

lotion Anti Nyamuk )
-

Kemoprofilaksis CO bat Ean )

↳ Area
Senate Klorokuin

| *
Klorokuin
( 150mg )

Area Resister Klorokuin

2Tab/mgu (
l Tab :
lmao sebelum.se/ama.4mgusesudah )

1st Dokstflklin too mgthr ( I -2 hrsebewm ,

selama , 4 mgu sesudah )

2nd Meflokuin Hab ( 250ms 1/mgu( 2 mgusebelum.se/ama.4mgu5esud' ah )

Maths : 6 Bulan , CDC : Indonesia -

-
Resister klorokuin

Ibu Hamil & Anak Lattin : theflokuin

Check point 111
 Leptospirosis
↳ eho spiral
leplospira ( Batten Bentuk
-

Vettori Tlkus ( Urim Titus )

FR pekerjaan pembersihselokan
:
, Raw kebanjiran ,
Rumah lantai Tanah

Klas#Kasi / Diagnosis
I .

Leptospirosis Rangan / Antler it Leptospirosis

Demain Nyeri Betis ( Gastro themes ) t conjunctival sufussion ( Mata Merah )
" "
+

tf Rct)

2 .

Leptospirosis Berat l l Klenk leptospirosis / Well 's Disease

Gejala I .
Rangan + lkteriklohgouria

P penunjang
.
:
Awal ( DR leukosltosls
:
, Fungsi hati 560T SGPT , , fungo Gingal Ureomlcr )
Derek Mlkroskop lapan Dan pandang Gelap ( Darkfield microscope )
:
-
-

Hu
Kumari spiral Bercahaya
-
Kultur darah ( Gold standart )
-
lndlrek : -

Serologi Anti leptospira MAT :

( Microscopic Agl utination Test)

④

3901 . flak'tam

3601 Cefalosporin
.
 Demain TyFold
↳ eho Salmonella
: Typhi ( Batang ,
Gram Neg )
Trans mist : Fecal - Oral

DX :
- Demain > thr ,
Demain Tpd sore -
Malam hr ( stepladder Fever )
-

Konstipasi I blare , nyeri pent -

PF : lldah Kotor Te pi
Hiperemis Lldah Tremor ( Typhoid Tongue )
I
.
,

Bradt Karoli Relate :( Cth :

Temp telapi
40°C HR 58×1ment )
-

Rose spot ( Benak Merah di da dat

P penury ang
.

1. Nidal Test
034320
'

Ct ) jlka titer atau T 4x4pat

2. Tubex Test
(t ) jlka 7 f- 4
, Ctlkuatjlka 71-6
3. Kultur : Daran ( Athir mgu
1 )
(media empedu ) Feces ( meu 2 )
( Gold standart ) U Mn
( m gu 3 )
Th :

Non FarmaKo
- : Bedrest ,
Diet Lunar TKTP ,
Rendah se rat Ctperforasi Hsus )
-

Far Mako
Dewas a 1st Quinol on ( 7 -

14h r ) Ibo Hamil

-

Cyprofloxatln 2×500 y 1st Gol B laktam ( 7 14h r)

-

2nd Gol Cefalo porch G- 14h r)

.

Ofloxaeiri 2×400 y
-

2nd Cefalosporin
-

Drips ceftriaxone 3-4 9r/hr ( shr )

Ce MSIKSBB Ihr Cdlbagi 2 doses ) ly hr
flame tab
-
20 f
-

( 2x 60oz )
Anak ? 1st Kloramfenlkol 25 -
50 tylkg RB Ihr ( dtbagi 4 doses ) 7 -

14 hr

( ES :
Pansltopenia Sekunder)

Tlamfenlkol Cleblh dlplllh )

Kompukasi Perforasi : Usos
Check point ! !
HIV tampa Komphkasi
↳ etio : Virus HIV

Transmisi : Calran Tubuh ( sets BeBas , PengDona Tarun , Ibu HN

yg melahirkan anak)

Klas# Kasi ( Std Kunis )

I .
HIV Std I 4 .

HIV Std IV

A HIV dgn Wasting syndrome

simp Tomah
-

K -

Llmfadenopati general isata -

Pneumonia PCP ( Pneumocystis Carn ii

Pneumonia)
2 . HIV Std I -

Toxoplasmosis Ense fautis

-
d BB Clo % ( Dx :
HIV t t ke sad aran )
-
Stomatitis CT scan : Ring enhancement lesion

Herpes 200 Ster -

Candidiasis eso Fagus

-
TB Ekstra pan (TB Twang )
3 .
HIV Std III
-
d BB 7102
-
Denham ? > I Bulan
-
blare ? 7 I Bulan

- Oral candidiasis Coral Thrush )

-

TB Pan

AIDS =
HIV Std 1111N 1 Std
berapapundgn 42350

Pcpenunjang .
.
-

Rapid FestAnti HN 3x
-
ELISA 3 meto de
-
Western Blot
-

Kadar CD4
Per Menkes HIV 2016 :
IndiKasi ARV jlka HN Std H1N1 CD4 4350
Permeates HIV 2019 : Indi Kasi ARV ylka Rapid Test t t t 7
Terapi )
singer loan diagnosis
( CD4 :
Yera Wasi l
Oporhsmshk
Tatalaksana ARV
Cnfekfi TE
Tenetama -

2 NRTI t I NNRTI
-

Tenofovir (TDF ) -

Efavlrenz CEFV )
-
Lambdin ( 5k) -
Neutrapin ( NVP)
-

Zidovudine ( ZDV )

1St Ten of our t Lamwudin + Efavirenz ( THE txt )

2nd Lamivudintt 2140W din t Efaw rent

HIV TTB : obati TB - ④ Arv ( OA Tt ARV )

2 8 mgu
( OAT )
-

R (Y hindari Reaksiobat ) 30 bat

H
Z

E
 !
Checkpoint
 ⑦ Sentai : BAB ,
Berlendir darahct)
,

--
Dlsentri Basher ( lying dysentriae) Disentri Amoeba ( walking
dysentnae)
etio : Shigella Dysentriaelshlgellosis Cho : Entamoeba Hystouhca
( Batang , gram Negi) / Amoebas is

Plg searing Usta L5Thn ptg Serang Usta 75 Thin

Klink lebih berat Kunis lebih Ansan
Dx : Trek BAB > lox/hr Dx : Trek BAB Lloxlhr
Demain 738°C Demain 2380C
Nyeri pent Nyeri pent
onset L IMDU onset > I Mlnggv

Ppenunjang : -
feces Putin :
Kota Trofozott Kristal
, .

P' penuryang : - Serologi Amoeba :

Charcot leyden
( Seroamoeba) t
-

Pewarnaan Gram
-

Kultur feces

Trofozoit : Amoeboid pecahaneosinofil

Kiske : Bulat . until -4 memakanentroslt
cent Ct) ( ingested RBC)

Th :
Dewasa 1st Metronidazole 3×500 V
Th :
Dewasa 1st Quinol : on
Cs lohr )-

ciprofloxacin 2×5008 Ehr) Anak ? 1st Metronidazole

2nd kotnmoksazole 2x 960mg 30 mslkgbrslhrcdibaci 3 dos 's)
( 5 thr )
- 5 -
thr

Anak? 1st Kotrlmoksazole to m9lk9BD/hr Kompllkasi Abses -

. Liver
( dlbagi 20105145 thr -

Kompllkasi .

Sepsis
 v Balantidlasis
↳ eno : Balantedium Coli
Dx ..
Sindroma Disentail
P penury ang feces Putin
. : :
Klstatrofozoit 2 Inti

Inti makronukleus
Inti mlkfonukleos
1st Tetrasittin 4x5ooy ( 7 lohr)
'

Th :
-

2nd Metronidazole 3×500 y (5 lohr) -

v Giardia sis
↳ eko Giardia : lambHa
Dx : -
Diane Berminyak Berlemak ,

-
lender C I darah C I
- -

BerBau Amis
-

Perret Kembond
P penuryang
. : Feces Putin Baraat Bentuk Buah par
:
, yg
Terbalik ,
Inti 2 ,

Flaget Ctl .
"
Seperti monster
"

th :
Dewas a : Metronidazole 3×250 VCs -
thr )

Anak ? Metronidazole my IKSBB

Ihr Cdl bag, doses )
'

is 3 s -

thr

v Kobra
↳ eko Vibrio Korra A Kultur feces
penuryany
-

: .
.

Transmi si Air Yg Terce Marr Th 1st Tetras, Klin (5- tohr )

'

:
-

: 4×500 y

Dx Feces seperticuaan Bera S

: . 2nd Doksislklln 300mg ( SD )

Trek BAB 710 X/hr-

Dehidrasi syok (tf )-

"
-
"
Washer woman d Hand
 lhfeksi coking ( KU : Dare Tdk
,
konsenlrasi Tumbuh Thembang Terhambat Anemia)
, ,

1 .
Schistosomiasis / Bilharziasis
( Gol Trematode)
.

exo :

O .
O . Q
Schistosoma S mansoni S
japonicum
- -

ftematoblum
Dx : Diane Ctdk Khas) ,
Hematuria

kaswo.gg#siariasina9ithYnY.ersws →

→
Spina ( Teller)
is to Soma
,

P penuryang feces
.
: in
- :
Telur oral + spina
Th :
praziguanlel long 1kg BB (SD)

2. Taeniasis :
lacing Pita
(Gol Cestoda )
etio : Taenia saginata CD Sapa ) T Solum CD Babi )
.
, .
.

FR :
memakan duping yg Ku rang Mata ng

Std Infernus slshserkus

Yg termathan
:

DX : Dare (Tdk Khas) t FR Ctl

P penuryang
.
:
Feces Putin : Teller, Proglotid
Teller : Bulat , duding Radial
seperti
"
Roda Pedati "
 -

Proglohd : T Solum : 5 -
IO ca bang
30 Cabang
(Potongan T Sagi nata
. : 15 -

Tubuhcaang )
-
Scolex
T Solum
. - a Rostellum Ct )
T sayin ata
. → Rostellum C I -

Kompukasi : Neurosishserkosis
( etio : T Solum .
,
tkesadaran.FR Ct )
CT scan :
Ring enhancement lesion

Th : Taeniasis :
Praztquantel to mglkgBB CSD )

NeurosisHserkosls :
Albendazole 2×400 Mg (8 -

30 hr )

3 .
Enteroblasts ( got Nemaloda) , Oxyuriasis : facing Kemi
etlo : E. Vermicular is / Oxy Uris Vermicularis

FR :
Makan talk cuci Ten
StdInterns Telur yg TermaKan :

Dx fatal di Du bur
:
pal malam hari
P penury ang
.
: And swab / Graham Scotch
Adhesive tape pd pasi hari
I

Th :
Telur Oval pipih pd l Sisi asimetris
planokonveks sepertitluruf DCM
1st pyrantel pamoate
,

,
,

long IKGBB ( SD )
!! )

2nd Me bend azole 500mg 1600mg (SD)

2×100 MS ( 3 hr )
 acing
4. Trlkunasis ( Gol NemaNda ) : cam but

exo : Trichuris Trichura

FR : Makan folk cuci Ten
Std Interest us : Telur acing
Dx : Diane ( Tdk Khas )
Turun (prolapses Recti komphkasi)
keyword
3T
→ :
:

→
Tong Item payan (Telur)
→ Trichuris

Pcpenunjang : feces Putin Tongtempayan

:

"
Double knob
"

Th :
1st Mebehdazole
2nd Albendazole 400mg (SD )

5 .
Askarlasts ( cool Nematode ) Caa
ng
exo : A scares Lumbricoldes : Gela
FR : Makan talk Cua Tsn
ng
Std .

lnfeksws : Telur lacing

Dx : -
BAB keIvar caring seperti mid
-

Sind roma hoefler (gejala Sal .

nqpas krn acing )

-

facing dpt Keluar dr mullet

-

Ileus obstruksi
P penuryang Feces Putin
. .
.
: (Albuminoids
Teller dlndlng ,
Tebal ,
Bertapls , Bergen gi
Th : 1st Albendazole
2nd Mebendazole
 6. Hookworm ( Gol . Nematodes : Caa ng Tam Gang

etio Ancylostoma duodenale

} Achedimuasoshaws
:

Necator Americanus )
A. inurn
g creeping eruption
can

A. Brasiliensis ( di Koht)
Std lnfeksius : larva Flanform
FR : tidal pakai Alas Kaki

Dx : Anemia ( 5L )
P Harada
"
Feces Rutan Mori Test
"

penury ang
.
:

I
Telur , oral , dindlng Tipis e TransParan
segmented ovum di dalamnya
Th : 1st Albendazole
2nd Mebendazok

Filariasis
↳ etio : louche ria Bancroft Brug ,a Malayi
, Brugh Timo ri ,

Vettori Hyamup Culex ( Std InteKaos larva ygmasuk Ke Ku IH :

melalui gig Han
nyamuk)
Dx : aKut i
Demain t 4mFadenitis
Kunis :
Limeedema .
elephantiasis ( Kaki Gajah)

B. malay W Ban Kroft

'
'

Dx :
limeedema .
.

Limfedema Yd lipatpaha
talk sampaiupat -
edema skrotum
Pana -

kurta
( BAK Putih Susu )
 P penuryang
.
: A pusan darah Epi pd malam hari ( pukul 2200-02-001
I
MIKN filarial paraSH Bennie sand rise Berselubung

MIKAfilaria
l .
W Bankrofti Inti
.
:
halos Tera for , , Inti C-I dieKor , cephalic space l : I

2 .
B Malay i
.
:
Inti Kosar , Tdk Teratur ,
Inti CH di e Kor ,
2 : I

B Timon
"
3 I
'

3 -
.
: "
i . i .
:

tn-taencarbamazm.fi?n:::::Y!d::Y:dos's
-

Operate
Profllaksis :/ I tahun : 1st DEC 6mgASBB (SD ) t Albendazole 400 MS CSD)

2nd Ivermectin '

150-200 Mcg t Albendazole 4001ms ( SD )

✓ Tetanus
↳ etio .
. Clostridium Tekin, ( Batang , gram posh f anaerobe sporactl di Ujung
'

"

Seperh Korek api Raket Tenis

" '
" "

Transmisi Luka masur ( Iuka Tusuk Luka talk stern )

:
,

oth : Tetanus neonatorum

( DX By : Br tahir , mullet men Coco , Rw tahir di DUK Un )

Dx :
Trismus Rahane Kako :

Asus Sardonlkus Najah Menyerlnga : .

Opes totonus i Badan seperti Busor

Klas#Kasi Albeit
1. Tetanus gr I ( Rangan ) :
Kaku Ct) kgangc I -

2 .
gr II ( Sedano) : Kaku Ct) kgangct ) Rang sang
3- gr III ( Berat ) : Kaku Ct ) kjangcts Spon tan
4 .

gr N ( Sgt Berat ) "

" "
, Dlsfungsi
Autonom

P penury ang
.
:
-

Pewarnaan Gram ( TDTH.HN/u )

-

Kultur swab Luka

Th :
-
Isolasi Bang Delap e Tenancy
di
-

Anti Taksin 1st Http 3.000 6. ooo -

w ( IM ) ( SD )

2nd ATS 50.000 -

too Oo to
.
CES Alergi ):

AB 1st Metronidazole Drips 500 my 16 ojam

-
(7 -
lohr)

2nd lnj 16dam lohr)

'

penicillin G 2.4 Jun w (7 -

Kako Hyang :
Diazepam

Profhaksis
LangKah t :

TanyaKan Rlw -
lmumsasi Tetanus
Tidal perv Ttckec do fffaakhhtt )
'

takin leno Kap ( 3 doses ) →

.

Volkan tdklengkap ( S3 does Kupa) perk TT ( Tetanus Toxoid ) - a

Lang Kah II : Lahat Luka ! !

-

Luka Bersih Kecil ,

:
Tdk perk HTIGIATS
-

Luka Kotor Besar lmumsasilengkap Tdk perk HTICSIATS

L
, F- :

+ Debridement Luka ! !
.
imumsas , talk lengkap :
Perk THIS IATS
 PMN i MN .

- in
Basofh ( Eos / Neuroth lllmfosit lmonostt
12-81
1132
O -
the / 50-702 / 20-402
,
.

Tltfeksi Bakari ;
I
4 Akrgi , Mt lnteksi TBC
T lnteksiparaat facing g th lnteksi virus

"
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-
e -
,
-