BAB II

PNEUMONIA
Infeksi peradangan akut parenkim paru

Normal → terisi udara

Pneumonia → nanah dan cairan

World Health Organization. Pneumonia [internet]. 11 November 2021. – Diakses 4 September 2022. Available From: https://www.who.int/news-room/fact-sheets/detail/pneumonia
Epidemiologi
WHO 2019 → usia <5 tahun 740.180 meninggal
14% dari total kematian anak <5 tahun

World Health Organization. Pneumonia [internet]. 11 November 2021. – Diakses 4 September 2022. Available From: https://www.who.int/news-room/fact-sheets/detail/pneumonia
Epidemiologi
RISKESDAS 2018 → Terbanyak Jawa Barat 186.809 orang atau 4,7% dari
total penduduk.

Sumatera Barat → 20.663 jiwa dan 2.179 terjadi pada balita

Kementerian Kesehatan. Riset Kesehatan Dasar Tahun 2018. Jakarta; Desember 2018.
  Etiologi
• Virus (Human Respiratory syncytial virus)
• Bakteri (S. Pneumoniae, HiB, Mycoplasma Pneumoniae, streptokokus
grup B, Klebsiella, Escherichia coli, dan Listeria monocytogenes)
• Jamur (pneumocystis jiroveci)

GBD 2016 Lower Respiratory Infections Collaborators. Estimates of the global, regional, and national morbidity, mortality, and aetiologies of lower respiratory infections in 195 countries, 1990-2016: a
systematic analysis for the Global Burden of Disease Study 2016. Lancet Infect Dis. 2018 Nov;18(11):1191-1210.
 Faktor Risiko
• Kelompok usia <2 tahun dan >65 tahun
• Rawatan di rumah sakit
• Orang dengan penyakit kronis
• Orang yang merokok.
• Orang defisiensi imun.

Vivi Ninda Sutriana, Mei Neni Sitaresmi, Abdul Wahab. Risk factors for childhood pneumonia: a case-control study in a high prevalence area in Indonesia. CEP. 2021;64:588-595.
 Faktor Risiko

Bengoechea JA, Sa Pessoa J. Klebsiella pneumoniae infection biology: living to counteract host defences. FEMS Microbiol Rev. 2019 Mar 01;43(2):123-144.
 Klasifikasi
• Community-acquired pneumonia.
• Hospital-acquired pneumonia.
• Health care-acquired pneumonia
• Pneumonia Aspirasi

Vivi Ninda Sutriana, Mei Neni Sitaresmi, Abdul Wahab. Risk factors for childhood pneumonia: a case-control study in a high prevalence area in Indonesia. CEP. 2021;64:588-595.
Patofisiologi

Zar HJ. Bacterial and viral pneumonia: New insights from the Drakenstein Child Health Study. Paediatr Respir Rev. 2017 Sep;24:8-10.
Patofisiologi

Zar HJ. Bacterial and viral pneumonia: New insights from the Drakenstein Child Health Study. Paediatr Respir Rev. 2017 Sep;24:8-10.
Patofisiologi

Zar HJ. Bacterial and viral pneumonia: New insights from the Drakenstein Child Health Study. Paediatr Respir Rev. 2017 Sep;24:8-10.
Patofisiologi

Zar HJ. Bacterial and viral pneumonia: New insights from the Drakenstein Child Health Study. Paediatr Respir Rev. 2017 Sep;24:8-10.
Patofisiologi

Kongesti Hepatisas
Vaskular i Merah

Hepatisas
Resolusi i Abu-Abu

Zar HJ. Bacterial and viral pneumonia: New insights from the Drakenstein Child Health Study. Paediatr Respir Rev. 2017 Sep;24:8-10.
 Manifestasi Klinis
• Batuk
• Demam
• Takipnea
• Dispnea
• Sianosis
• Malas makan ataupun menyusu

National Center for Biotechnology Information. Pediatric Pneumonia [internet]. 8 Mei 2022. -Diakses 5 September 2022 Available from: https://www.ncbi.nlm.nih.gov/books/NBK536940/
 Diagnosis
Anamnesis
• durasi gejala
• Pajanan
• Perjalanan
• riwayat kontak sakit
• riwayat penyakit kronis
• gejala berulang
• Tersedak
• riwayat imunisasi
• kesehatan bayi
• komplikasi kelahiran pada neonatus
National Center for Biotechnology Information. Pediatric Pneumonia [internet]. 8 Mei 2022. -Diakses 5 September 2022 Available from: https://www.ncbi.nlm.nih.gov/books/NBK536940/
 Diagnosis
Pemeriksaan Fisik
• Observasi distres pernafasan
• Auskultasi: rhonki dan penurunan suara nafas

National Center for Biotechnology Information. Pediatric Pneumonia [internet]. 8 Mei 2022. -Diakses 5 September 2022 Available from: https://www.ncbi.nlm.nih.gov/books/NBK536940/
 Diagnosis
Pemeriksaan Lanjutan:
• Pemeriksaan laboratorium
• Pemeriksaan Radiologi

National Center for Biotechnology Information. Pediatric Pneumonia [internet]. 8 Mei 2022. -Diakses 5 September 2022 Available from: https://www.ncbi.nlm.nih.gov/books/NBK536940/
 Tatalaksana

Suportif Simptomatis
• Antibiotik • Oksigen
• Drainase • Antipiretik
• Cairan

Matera MG, Rogliani P, Ora J, Cazzola M. Current pharmacotherapeutic options for pediatric lower respiratory tract infections with a focus on antimicrobial agents.  Expert Opin Pharmacother. 2018 Dec;19(18):2043-2053. 
 Komplikasi
• Empiema
• Efusi pleura
• Abses paru
• Pneumonia nekrotik
• Sepsis

Matera MG, Rogliani P, Ora J, Cazzola M. Current pharmacotherapeutic options for pediatric lower respiratory tract infections with a focus on antimicrobial agents.  Expert Opin Pharmacother. 2018 Dec;19(18):2043-2053. 
 Prognosis
Baik
• Tanpa penyakit kronis
• Tidak immunosupresi

Jain S, Williams DJ, Arnold SR, Ampofo K, Bramley AM, Reed C, et al. CDC EPIC Study Team. Community-acquired pneumonia requiring hospitalization among U.S. children. N Engl J Med. 2015 Feb 26;372(9):835-45.