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Sosialisasi Diagnosis Dan Tata Laksana Leptospirosis Di Dki'
Sosialisasi Diagnosis Dan Tata Laksana Leptospirosis Di Dki'
2
Broad range clinical presentations (syndromes)
Anicteric Leptospirosis, atypical, relatively mild 80-90%
Flu-like or as acute undifferentiated fever
Underdiagnosed, not included in the DD of acute fever, then not
tested
Can be misdiagnosed as other prevalent infectious diseases
Patient may not seek medical attention
MH Gasem
Sepsis-like phenotype
Mild Leptospirosis (anicteric leptospirosis)
mimicking other acute febrile illnesses
environment
What are the history of exposure to
Leptospira-contaminated environment ?
Walking in flooded streets or stagnant water
Living in flood prone areas
Personal hygiene, wounds
Large rat population
Recreational exposures (water sports, triathlon etc)
Occupational risk factors: farmers, cleaners etc
Suspect case
Acute fever, headache, myalgia, conjunctival suffusion
Exposure to leptospira-contaminated environment
AND / OR
Any three of the following:
1. Urinary : proteinuria, leucocyte and erythrocyte
2. Relative neutrophilia (>80%) with lymphopenia
3. Platelets < 100,000 per µL
4. Elevated serum bilirubin (>2 mg%); CPK and amylase.
Leptospirosis Case definition
Confirmed case
PCR positive
Culture positive: Isolation of Leptospira sp from clinical specimens
Laboratory diagnosis of Leptospirosis:
1. Antibiotic treatment
2. Supportive care
1. Antibiotic treatment
2. Supportive care
Clinical studies of antibiotics in Leptospirosis
Cefotaxime (1 g IV q8h)
Ax:
Demam 3 hari, nyeri kepala, nyeri otot, mual, muntah , nyeri perut
Tempat tinggal: Semarang kota, daerah bawah (rawan banjir).
Pekerjaan: tidak bekerja
Lab:
Darah: Lekosit : 12.700, Trombosit: 114.000
Lepto Tek Lateral Flow: negatif
Px:
Dehidrasi, sclera ikterik, ada conjunctival suffusion
Nyeri tekan gastrocnemius tidak ada
Lab: Lekosit: 14.800; Trombosit: 89.000, Lepto Tek lateral Flow: positif
Ureum: 126, creatinin: 2,04, Bilirubin total: 4,1, direk 3,7
10
8
Jumlah Kasus
40
35
30
25 Puncak
20 musim
hujan
15
10
052 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Situasi leptospirosis 2019
Sebaran Kasus Leptospirosis Jan - Des 2019 DKI Jakarta menurut Jenis Kelamin dan
Kel. Umur
25
20
15
10
0
4 - 17 th 18 - 60 th ≥ 61 th
0 2 4 6 8 10 12 14 16 18
8 Tren Bulanan Kasus Leptospirosis DKI Jakarta Tahun 2019
7
7
6
6
5
5
4
3 3 3 3
3
2 2 2
2
1 1
1
0
Januari Februari Maret April Mei Juni Juli Agustus Sept Oktober Nopember Desember
7
Puncak
musim
6
hujan
5
KESIAPSIAGAAN
4
0
Jan-18 Feb-18 Mar- Apr-18 Mei- Jun-18 Jul-18 Agust- Sep-18 Okt-18 Nop- Des- Jan-19 Feb-19 Mar- Apr-19 Mei- Jun-19 Jul-19 Agst-
18 18 18 18 18 19 19 19
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