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Demam Tifoid: Dr. Suhaemi, SPPD, Finasim
Demam Tifoid: Dr. Suhaemi, SPPD, Finasim
Demam Tifoid: Dr. Suhaemi, SPPD, Finasim
Dr. SUHAEMI,
SpPD,FINASIM
DEMAM TIFOID
Merupakan penyakit sistemik akut yg
disebabkan oleh infeksi kuman Salmonella
typhi atau Salmonella paratyphi.
DIAGNOSIS:
Gall bladder
shedding, weeks
Gastroenteritis
Sakit kepala, nyeri otot, anoreksia , mual,
muntah, obstipasi atau diare.
PEMERIKSAAN FISIS:
LED meningkat
TrombositopeniaAnemi ringan
Gangguan fungsi hati
Kultur Darah Positif
Peningkatan Titer uji Widal > 4x
Uji Widal dgn titer antibodi O 1/320 atau H
1/640
ANTIGENIC STRUCTURES
O antigen
Lipopolysacchride
H antigen
Flagella
K antigen
Capsule
Vi antigen
In Salmonella Typhi,
the capsular antigen is
called Vi antigen
PATHOGENESIS
The organisms enter via the oral route
With contaminated food or drink
The mean infective dose to produce clinical
infection in humans is 105108 salmonellae
butperhaps as few as 103 Salmonella Typhi
organisms
PATOGENESIS
stomach
(PEYERSPATC
HES)
(TYPHOI
D
NODUL
E)
MAJOR FINDINGS IN LOWER ILEUM
Hyperplasia stage(1st week):
swelling lymphoid tissue and
proliferation of macrophages.
Necrosis stage(2nd week):
IgM
Widal test
SPECIMENS FOR LAB DIAGNOSIS
Blood for culture must be taken repeatedly
In
enteric fevers and septicemias, blood cultures
are often positive in the 1st week of the disease
Bone marrow cultures may be useful
Urine cultures may be positive after the 2nd week
Stool specimens also must be taken repeatedly
In enteric fevers, the stools yield positive results
from the 2nd or 3rd week on
In enterocolitis, during the first week
A positive culture of duodenal drainage
suggests the presence of salmonellae in the
biliary tract in carriers
TERAPI
NON FARMAKOLOGIS
Tirah baring
Makanan lunak rendah serat
Vitamin dan Mineral
FARMAKOLOGIS
SIMTOMATIS
ANTIMIKROBA
Kloramfenikol 4x500
Ampisilin 4x1 gr
Deksametason 3x5 mg
KOMPLIKASI
PERDARAHAN INTESTINAL
PERFORASI USUS
ILEUS PARALITIK
PANKREATITIS
PROGNOSIS