slide lapkas ariza.pptx

7/24/2019 slide lapkas ariza.pptx

http://slidepdf.com/reader/full/slide-lapkas-arizapptx 1/21

Case Report

NON DYSENTRIFORM ACUTE DIARRHEA(A09) + MILD-MODERATE DEHYDRATION

AUTHOR : ARIZA ZAKIA IMANINIM : I11110009LECTURE : DR. HILMI KURNIAWAN RISKAWA, Sp.A,M.K!DATE " DAY : #1TH OCTO$ER #01% " WEDNESDAY



Identitiy

Q, boys, 2 years 10 month, was care inDahlia Room, Kartika Husada Hospital, or !days, rom "ctober 1#th 201$ to "ctober1%th 201$



Chie ComplainDeecate a watery stool



•&omitin' ater e(ery meal and drink since 1 daybeore hospitali)ed

•*atient deecate a watery stool with 1$, ayellowish color stool, with no presence o mucus orblood

•+ sudden hi'h e(er, with no sei)ure

•*atient looks thirsty and still want to drink water,but dont want to eat•

"ther complaints such as cou'h and cold,dyspa'hia denied by patient•-rinate as usual,normal

•% hours beore hospitali)ed patient brou'ht topuskesmas and 'i(en dru' to treat the e(er,nausea, and antibiotic, but the patients condition

12 hoursbeore

hospitali)ed

1 day beorehospitali)ed

$ hours beorehospitali)ed



*atient has ne(er e/perienced a similarcomplaints beore, ha(e no history o

sei)ure, thypoid e(er, DH, andasthma.

o amily members with a similarcomplaints

Completed (accination as schedule

History o 'rowth and de(elopment isappropriate with any normal children

Drink a milk made by condensed milkow hy'iene since the patient oten

dont want to wash hands ater playin'outside house



&'!* E//

3eneral appearance 4 moderate sick, weakness+wareness 4 Compos mentis

+ntropometry

5ei'ht 4 11 k'

Hei'ht 4 61 cmwei'ht7a'e 4 82 9D

hei'ht7 a'e 4 0 8 :82; 9D

5ei'ht7hei'ht7 4 below81 9D

utrition state 4 normal



3eneralist 9tatus

&ital si'nHeart rate 4 1$0 /7s, re'uler, stron' in palpableRespiratory Rate 4 #2/7s, re'uler in rythm,

thoracoabdominal type <emperature 4 #=,$ o C

Head4 normochepal

>ye 4 Con?un'ti(a anemic :878;, sclera icteric :878;,sunken eye :@7@;, pupil isokor diameter # mm7#mm,tears :@7@;

>ar 4 secret :8;,

ose 4 asal Aare:8;, Concha hypertroB:8;outh and throat 4 dry lips and mucosa :@;, hyperemis

:8;, cianosys :8;

eck 4 suprasternal retraction :8;, enlar'ement o

lymph nodes :8;.



• un' 4 basic breath sound (esicular inri'ht and let lun', whee)in' :878;, rhonki :878;

• Heart 4 91, 92, re'uler, murmur :8;,

'allop :8;• +bdomen

• Inspection 4 dome8shaped, mass :8;• +uskultation 4 bowel sound :@; increased•

*alpasi 4 hepar and lymph are notpalpable• *erkusi 4 tympani in all Bled

• +nus E 3enitalia 4 no abnormality• >/tremity 4 warm akral, Capillary Refll Time

:CR<; F2 detik, cyanosis :8;• 9kin 4 Colour o skin is brown, icteric :8;,

petechie :8;, rash :8;, tur'or :@; returned slowly



Glood <est1# "ktober 201$

ormal

5GC 22.00 7 mm# !000810.$00 7mm#

RGC $.$6 ?uta #,$0 $,$0 ?utaHemo'lobin 1!, '7dl 12,$81%,1 '7dl

HC< !%,6 J #%8!J

*< $$=.000 7mm# 1$0.000

!00.000 7mm#

GDS 59 mg/dL 100-200 mg/dL



Dierential Dia'noseon dysentriorm +cute diarrhea @ mild8

moderate dehydration

Dysentriorm +cute diarrhea @ mild8moderate dehydration



5orkin' Dia'nose

on dysentriorm +cute diarrhea @ mild8moderate dehydration



<reatment

• +(oid ecal8oral transmission.• I&D R 2% tpm makro• Ceota/ime #/$00 m' i(• +mpicillin !/$00 m' i(• *C< in !/12$ m' i(• "ndansentron #/1 m' i(• Ranitidin 2/10 m' i(• bio 1/1 sach•

Lync kids syrup 1/20 m' po



12"10 1%"10 13"10

9-G

M>C <I&

>

Deecate a waterystool 2/ :@;,&omitin' 1/ :@;,

e(er :@; , drink:@;, -rinate:@;,eat less

Deecate a waterystool #/ :@;,&omitin' :8;, e(er

:8; , drink :@;,-rinate:@;, eatless

Deecate a sli'htdense stool 1/:@;, &omitin' :8;,

e(er :8; , drink:@;, -rinate:@;,eat as usual

""5 -*



12"10 1%"10 13"10

"G M>

C <I&>

3eneralappearance 4moderate sick, RR#2 /7m, HR 120

N7menit, <4 #, C,sunken eyes @7@,tears @7@, wet lipsand mucous,tur'or returnedast, abdomen

supel, tympanic,bowel soundnormal.

3eneralappearance 4'ood, RR #2 /7m,HR 120 N7menit, <4

# C, sunken eyes@7@ minimal, tears@7@, wet lips andmucous, tur'orreturned ast,abdomen supel,

tympanic, bowelsound normal.

3eneralappearance 4'ood, RR # /7m,HR 11! N7menit, <4

# C, sunken eyes878, tears @7@, wetlips and mucous,tur'or returnedast, abdomensupel, tympanic,

bowel soundnormal.



Discussion



&45 6 *!

Dia'nose <reatment

*ro'nose



Dia'nose

ID+I. Pedoman Pelayanan Medis IDAI. Makarta4 ID+I. 20064 $=8$6.

+cute Diarrhea4

Deecate more than #times in 2! hours5atery stool, less

than 1 week&omitin'

Dehydration si'n49unken eyes

ethar'y

<hirsty <ur'our returned

slowlyDry lips and mucous

*atient si'n andsymptom4

Deecate a waterystools 1$ times&omitin'

9unken eyesethar'y <hirsty

<ur'our returned

slowlyDry lips and mucous



Disentrirom Diarrhea waterystool with mucus and blood,e(er, tenesmus ani, pain in

abdomen, prolapsus ani

on8 Disentrirom Diarrhea Kids under 2 y o, watery stool,

hi'h e(er, (omitin',accompanied by cou'h and cold

*atient watery stool with no

mucus and blood, hi'h e(er,(omitin'

9unoto. Penyakit Radang Usus : Ineksi dalam Buku Aar Ilmu !ese"atan Anak #!UI editor A.$. Markum dkk . Makarta 4 K-I.

16614 !!=8!%%..



<R>+<><

M7*/ F8/*/

I&D R 2% tpm makro Rehydration

Ceota/ime #/$00 m'i(

<o treat %. Coli& *re(entin' nosocomial inection

+mpicillin !/$00 m' i( <o treat %. Coli as secondary inection

*C< in !/12$ m' i( +ntipyretic

"ndansentron #/1 m'i(

+ntiemetic

Ranitidin 2/10 m' i( Inhibit 'astric secretion

bio 1/1 sach Inhibit the 'rowth o bacterial patho'ens

Lync kids syrup 1/20m' po

Reduce the duration and se(erity o diarrhea, increaseappetite



*ro'nose

Complication o diarrhea 4Dehydration>lectrolit imbalance

9ei)ure

Dye

+deOuate treatment can pre(ent thecomplication



<hank you

Documents

slide lapkas ariza.pptx