SJS-samudra.pptx

8/11/2019 SJS-samudra.pptx

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mrs.D

45 years

Cibereum

Islam

smp

married

housewife


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Skin peels since 3 days ago


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Fever

Headache

Coughing up phelgm

The eye balls become yellowish with anredish of the conjungtiva

Lost of appetite

Skin itch


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Patients feel fever for more than 1 weekspatient drink a drug ( doesnt know the name)

3 days after consumed the drug, patientcomplained about still feeling the

fever,headache and coughing up phlegm andpeeling on her skin that started from the lips andthan becoming a rash that surrounding herbodies and followed by itching of the skin

Patient loss her appetite 3 days before get in tothe hospital

And than 1 day before patient enter to thehospital, the eyeballs become yellowish and herconjungtiva become redden


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Patient never like this before

Patient never have an operating history

Patient never have an hospitalize history


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Patients deny that no ones in her family have

the same symptoms like she

There is no history of hypertension, diabets

Patients doesnt know that if she had anallergies to something


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Patients rarely consumed a drug if she sick

Patient has a good appetite ( she eats 3

times a day)


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General condition

awareness: compos mentis

Impression of pain: severely ill

Vital sign Blood pressure: 110/60mmHg

temperature: 37,4oC

Nadi : 84x/menit

Pernafasan : 20x/menit


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Thorax

Cor

I : ictus cordis doesnt seen

P : Ictus cordis palpable at between ribs VI lateral 2 fingers

from left midclav

Per upper limit : between ribs II lane left parasternal

- left limit : between ribs V lateral from left midclavlane

- right limit : between ribs IV right sternalis line

A : Core sound 1-2 reguler, murmur -, gallop -


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Thorax

Paru

I : shape and move simetricaly, there is no left

chest wall motion, there is rashP: same vocal fremity right - left

Per : sonor

A : breathing sound vesikuler, wh -/-, rh -/-


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Ekstremitas :

look : rash

feel : pain

move : active(+), passive(+)


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Steven johnson syndrome

Drug induced Hepatitis

AKI


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Toxic epidermal necrolysis

Erythema multiforme


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Laboratorium

Hb : 8 - Ureum : 284,3

Leukosit : 23.000 - kreatinin : 8,40

GDS : 51 - SGOT : 98

Trombosit : 335.000 - SGPT : 74

Ht : 22 - bil. Total : 21,0 Hitung jenis : 0/0/0/34/4/5- prot. Total : 6,03

D-Dimer : 8034,05 - albumin : 2,711

-USG : Hepatomegali- globulin : 3,32

- Fosfatase alkali : 736


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Steven jhonson syndrome

Sepsis

Aki

Drug induced hepatitis


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IVFD D5% 40cc

Amino inf + aminofusin hepar

Ceftriaxon inj 2x3gr (sepsis)

Lasix 2x1amp (eva. Urin) Ranitidin 2x1amp

As.folat tab 3x1

CaCo3 tab 3x1Metil prednisolon 2x12 mg

Curcuma (tambahan hepar protektor)

Heparin 50mg/kgBB diberikan dlm 20 jam


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Ad vitam : dubia ad bonam

Ad functionam : dubia ad bonam

Ad sanationam : dubia ad bonam

Documents

SJS-samudra.pptx