Teaching Bangsal Paling Baru

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TEACHING BANGSALHERPES ZOOSTERGroup MembersAkbar Kapita Baharsyah La Ode Muh. AkhiruddinLa Ode Muh. MukhlisinElys Dariatmo HerikFahri Dwi PermanaMuh. Samil GendaFitri IrmayantiDewi LasimparaDewi W SupangatUbudiah Nourmala RRizky FauzillahNur AisyahAndi Nur Fadhilah A

Patients IdentityName : Syarifah HalwiahGender : FemaleAge : 51th years oldMarital Status : MarriedReligion : MoeslemAddress: KalukueOccupation: Private sector employeesRegistered: 07th april 2014

Present StatusGeneral condition: Severe Consciousness: ComaVital signBP: 120/75 mmHgPulse: 88x/minute, regulerBreathing: 20x/minuteTemperature: 36,80 C

History TakingAnamnesis: AlloanamnesisChief complaint: Watery vesicel on the right abdomen regionFurther Anamnesis: knew by family about 4th day lasthing (3/04/2014) with fever history about +/- 3th day lasthing. Looking diameters size +/- 1 cm and grouping. Originally watery vesicel looked colored transparent and day to day become brown

Dermatology StatusLocation:Regio abdomen dextra (at thoracal 11th and 12th )Efflorescence:Group of bulla with eritema based

Examination FindingsRoutine Blood TestHB: 3,64 106/mm3RBC: 10,5 g/dLWBC: 12,5 103 HCT : 51Kidney Function Test:Ureum :. mg/dlKreatinin: .. mg/dlSGOTSGPTGDS

DiagnosisHerpes ZoosterManagementPK compres 1 : 10.000 (at morning and afternon)MBOAcyclovir 5x400 mg DEFINITONHerpes zooster is a painful skin rash. It is caused by varicella zoster virus, the same virus that causes chickenpox.Anyone who has had chickenpox or received chickenpox vaccine in the past may develop shingles.The risk of getting the disease increases as you get olderEPIDEMIOLOGYHerpes Zoster occurs throughout the year without seasonal prevalence. The Occurrence of herpes zoster is independent of the prevalence of varicella, and there is no convincing evidence that herpes zoster can be acquired by contact with other person. The incidence is determined by factors that influence the host-virus relationship.EtiologiHerpes zoster is caused by the varicella zoster virus (VZV), the same virus that causes chickenpoxAfter a person recovers from chickenpox, the virus stays dormant (inactive)The virus can reactivate years later.PatofisiologyDuring the course of varicella, VZV passes from lesions in the skin and mucosal surfaces into sensory nerves to the sensory ganglia.In the ganglia the virus establishes a latent infection that persist for life.Reactivation is sporadic and infrequentThe mechanism involved in reactivation of latent VZV are unclear but associated with immunosuppression, ect.When VZV specific cellular immunity falls below some critical level, reactivarted virus can no longer be containedVirus multiplies and spred within the ganglion a process that is often accompanied by severe neuralgia.Clinical ManifestationPainful Rash that develops on one side of the face or body (Unilateral)Pain, itching, or tingling often develops before the rashOther symproms : Fever, Headache, Chills, Upset Stomach

LaboratoryRoutine BloodVZV serologic assays Collecting and shipping bloodVZV PCR (polymerase chain reaction)HistopathologyDifferential DiagnosisVaricellaVaricella is a very contagious disease caused by the varicella-zoster virus (VZV) it caused a blister- like rash, itching, tiredness, and fever.

Varicella can be serious, especially in babies, adults, and people with weakened immune systemsTreatmentAntiviral agents: The nucleoside analogues acyclovir, famciclovir, valacyclovir, and brivudin

Antiviral Treatment of Varicella in the Normal and Immunocompromised Host

Topical TherapyAplication of cool compresses, calamine lotion, cornstarch help to alleviate local symptoms and hasten drying of vesicular lessions.For Immunocompromise PatiensAnti- Inflammatory TherapyAnalgesicsTopicalOral AgentsPrognosisHerpes zoster usually clears in 2 to 3 weeks rarely returns. If the virus affects the nerves the control movement (the motor nerve), you may have temporary or permanent weakness or paralysis