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STANDAR PELAYANAN MEDIS tentang RSUP FATMAWATI ENSEFALITIS

DISAHKAN OLEH DIREKTUR UTAMA :

Dr. H. Kemas M. Akib Aman S!.R MARS NIP "#$ $%$ &&' NOMOR DOKUMEN : HK.$$.$(.".)(* RE-ISI KE : " NOMOR RE-ISI : HK.$$.$(.". TAN++AL : *,*,&$$# TAN++AL :

". Judul / Topik : Ense.a/itis. &. Tanggal / Nomor / Up date : M0/ai % N1!ember sam!ai a2a !enata/aksanaan bar0 ses0ai Evidence Base Medicine. *. Scope Pengguna : D1kter Um0m 3 D1kter S!esia/is Sara.. #. Sumber Informasi : Misra M. In.e4ti1ns : -ira/ En4e!5a/itis E204ati1na/ 610rse. Literat0re 7-II 81r/2 61ngress 1. Ne0r1/1g9. L1n21n "( :0ne &$$". A2ams an2 -i4t1r;s. -ira/ In.e4ti1ns 1. t5e Ner<10s S9stem an2 Pri1n Diseases in Prin4i!/es 1. Ne0r1/1g9 (t5 e2. USA T5e M4+ra=,Hi// 61m!anies &$$" PP : (>* ? >$#. +i/r19 :. In.e4ti10s Diseases in @asi4 Ne0r1/1g9 *r2 e2. USA t5e M4+ra=,Hi// 61m!anies In4. &$$$ PP : #() ? #>). ). Nama Penelaah : Dr. T0ti H. S. Aa45aria S!.S. Se/0r05 Sta. SMF Sara.

'. Tingkat Eviden : 6. (. Protokol : (.". Definisi : In.eksi Baringan 1tak 1/e5 berbagai ma4am mikr11rganisme <ir0s 2an n1n <ir0s Cn1n <ir0s : !r1t1D1a mik1!/asma Bam0r bakteri s!ir145aeta 2an <ir0sE. Pen9ebab ter!enting 2an tersering ia/a5 virus antara /ain : <ir0s RNA Cm0m!s m1rbi//i r0be//a 2an g1/1ngan enter1<ir0sE 2an <ir0s DNA C5er!es <ir0s <ir0s <ari4e//a,D1ster 49t1mega/1<ir0s E!stein,@arr <ir0sE. (.".". Stadium / Ge ala !linis : (.".".". +eBa/a in.eksi ak0t : s050 men2a2ak naik n9eri ke!a/a m0nta5,m0nta5 kesa2aran 2engan 4e!at men0r0n keBang,keBang 2a!at bersi.at 0m0m .1ka/ ata0 5an9a Ft=i45ing; saBa. (.".".&. +eBa/a serebra/ : !aresis Cm1t1rik ata0 sara. krania/isE !ara/9sis a.asia ataGia !er0ba5an tingka5 /ak0 ke5i/angan 2a9a ingat.

(.".&. Diagnosis banding : (.".&.". Abses 1tak. (.".&.&. T0berk0/1ma serebri. (.".&.*. Metab1/ik ense.a/1!ati. (.".&.#. Meningitis. (.&. Diagnosis : (.&.". "namnesis : (.&.".". Kesa2aran men0r0n. (.&.".&. Panas tinggi. (.&.".*. KeBang. (.&.".#. Onset ak0t. (.&.".). +angg0an 2e.isit ne0r1/1gis. (.&.&. Pemeriksaan fisik : (.&.&.". +angg0an kesa2aran. (.&.&.&. TRM CHE ber0!a kak0 k020k Cbiasa 9a3ti2akE. (.&.&.*. gangg0an 2e.isit ne0r1/1gis .1ka/30m0m. (.&.*. Pemeriksaan Penun ang : (.&.*.". Lab. : 2ara5 /engka! S+OT3S+PT Astr0!3E/ektr1/it. (.&.*.&. F1t1 T51raks. (.&.*.*. L0mba/ !0ngsi C/i5at SPM L0mba/ P0ngsiE. (.&.*.#. @iakan 2ara5 2an /iI01r. (.&.*.). Pemeriksaan ser1/1gik. (.&.*.'. @rain 6T S4an. (.&.*.(. EE+. (.*. Penatalaksanaan Terapi : (.*.". Suportive : (.*.".". @ebaskan Ba/an na!as 2an 0sa5akan <enti/asi a2ek0at. 7.3.1.2. 6airan in.0s CI-FDE J misa/n9a Na6/ $ % % Asering RL ke40a/i 4airan 9ang 2a!at menamba5 terBa2in9a e2ema 1tak misa/n9a : 4airan 2ekstr1se "$K. (.*.".*. Per5atikan keseimbangan asam basa 2an gangg0an e/ektr1/it. (.*.".#. A!abi/a ter2a!at keBang atasi keBang !a2a 0m0mn9a C/i5at SPM KeBang !a2a bab Stat0s K1n<0/si.3E!i/e!siE. (.*.".). Ter5a2a! 5i!er!ireksia 2iberikan Fs0r.a4e 411/ing;. Da!at !0/a 2iberikan 5ibernasi Ck1mbinasi k/1r!r1maDin & mg3kg @@35ari 2an !r1metaDine # mg3kg @@35ari 2ibagi 2a/am * 21sisE 2an berikan anti!iretik C!ara4etam1/3Aset1sa/E. (.*.&. #edikamentosa : (.*.&.". Antie2ema 1tak 2a!at 2ig0nakan 4airan manit1/ &$K C21sis " ? & gr3kg @@35ariE ata0 k1rtik1ster1i2 Ck1ntr1<ersi br1a2 s!e4tr0mE.

(.*.&.&. Pemberian antibi1tika 2iberikan sam!ai terb0kti !en9ebabn9a. A!abi/a !en9ebabn9a b0kan bakteri antibi1tika 2i5entikan. Disam!ing it0 B0ga 0nt0k in.eksi sek0n2er. (.*.&.*. Pemberian anti <ira/ : <i2arabine C21sis ") mg3kg @@35ari s/1= I- L "& BamE. Da!at 2i/ar0tkan 2a/am 4airan Sa/ine 2an 2eGtr1se asa/kan k1nsentrasin9a ti2ak me/ebi5i $ ( mg3m/. Diberikan se/ama "$ 5ari. Hati,5ati !en2erita 2engan gangg0an .0ngsi ginBa/. A494/1<ir mem!0n9ai e.ek t1ksik 9ang k0rang 2iban2ingkan <i2arabine. D1sisn9a ") mg3kg @@35ari I- in.0s. Ke20a anti <ira/ terseb0t 2i/a!1rkan mem!0n9ai e.ek baik ter5a2a! <ir0s 5er!es sim!/ek. (.*.*. !onsultasi : (.*.*.". Re5abi/itasi Me2ik. (.*.*.&. Anestesi Bika 2i!er/0kan. (.#. Pemantauan : (.#.". Kesa2aran. (.#.&. KeBang. (.#.*. Perb0r0kan 2e.isit ne0r1/1gi. (.#.#. @a/an4e 4airan 3 E/ektr1/it 3 A+D 3 +DS. (.#.). Pen90/it : (.#.).". Pne0m1nia. (.#.).&. In.eksi Sa/0ran Kemi5. (.#.).*. Dek0bit0s. (.#.).#. Stat0s 61n<0/ti1n. >. Indikator !linis : @erat 3 ringan 2e.isit ne0r1/1gis Cm1t1rik 3 ner<0s krania/isE. CLi5at Tabe/ "E

Men9et0B0i Ket0a K1mite Me2ik

Dib0at 1/e5 Ket0a SMF Sara.

Dr. D129 Firman2a S!A MA NIP. "#$ "%$ #)(

Dr. Mar=ata/ H0ta2B0/0 S!.S. NIP. "#$ "&& '>%

TABEL 1 : Severity of acute encephalitis with defferent viruses


$I%US &ES' Rabies <ir0s Her!es sim!/eG <ir0ses Arb1<ir0ses L9m!5149ti4 451ri1meningitis <ir0s M0m!s <ir0sN 69t1mega/1<ir0s E!stein,@arr <ir0sN A2en1<ir0ses HIH0man 5er!es<ir0s ' +o.sa/kieviruses and e/hoviruses SE$E%IT( )* EN+EP,"-ITIS L %%K 1. 4ases are .ata/ L ($ K 1. 4ases are .ata/ Ci. 0ntreate2E " K , )$ K 1. 4ases are .ata/M C2e!en2ent 1n <ir0s an2 age 1. 51stE 61mm1n mi/2 en4e!5a/itisJ rare 2eat5s 61mm1n mi/2 en4e!5a/itisJ rare 2eat5s O44asi1na/ en4e!5a/itis =it5 in.e4ti10s m1n1n04/e1sis O44asi1na/ en4e!5a/itis =it5 in.e4ti10s m1n1n04/e1sis Rare 4ases 1. seri10s en4e!5a/itis in 45i/2ren Rare a40te en4e!5a/itis at t5e time 1. !rimar9 in.e4ti1n Mi/2 en4e!5a/itis in 45i/2ren %are fatal en/ephalitis in neonatus

6a/i.1rnia en4e!5a/itis is .ata/ in O " K 1. 45i/2renJ =estern en4e!5a/itis "$ K i. in.antsJ St. L10is en4e!5a/itis &$ K 1. e/2er9 !ers1nsJ an2 eastern en4e!5a/itis )$ K 1. in2i<i20a/s 1. a// ages. S1me .ata/ 4ases 5a<e t5e !at51/1g9 1. !1stin.e4ti10s en4e!5a/1m9e/itis. S1me <ir0ses ma9 4a0se a40te en4e!5a/itis an2 ADEM.

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