Anda di halaman 1dari 73

m 


 
   

      !"#$


IDENTITAS PASIEN
  $
%  & 
$  '#(
)     # 
$  * 
   ("" ' 

RIWAYAT PENYAKIT
  %  #    + (, 
  (  
 (
RIWAYAT PERJALANAN PENYAKIT SEKARANG
    (    #    
+ (,   (   (     
  (    &-./!  0  (   #  
   ( (  +   !#  
 (  (+ " #  #  #   !
     (  #  (  
   #   ((      
#1 # #      #  (  
#  (       ( 1  !
 (      #      (  
  ( #  ( "+ ( ( #  + (  2
(   (!   (  #   (    
   (  ( #   +   
3$3+ (º 

 1  (  "  ( #   (  1 (


&(     !#  4(#
  5    2(  
#  ( + +  (   
       !# 
   4 ( 24 (  ! 
 (  0 ( #   ( 
 1 3$3 "  ( 3$3#   4 !
  6 !(     (!  
4( ((  ! 2!
 2"  ( #    
3$3
 1 3$ 
4 ! 1 (!( !  (1  ( 
3$
RIWAYAT PENYAKIT SEBELUMNYA
è $  1        #!  
3  1  #   2    (
#    ' #   7 
      # # 
è $  1  
è $  1 #1 ( 0 (#   
 (( #    
è   (   1 (+ 
RIWAYAT KEHAMILAN DAN
KELAHIRAN
   ( 4(#   
  (  *#   ( ( 
(  1 4        
*#    ( ( (  1 
 
    (  (  ( 3   
(  
 # !   !
#  (  ( 0   (  4 4 0  (
 #    
3     &
 +     84
  1 (   #   
 (
Riwayat Pertumbuhan dan
perkembangan
 1   
   #  #    
       #    
 (  # (    
  # +   #     1 
 (( #   (  (  (( 
    " (  #   (
    & "#  
  
Riwayat Pertumbuhan dan
perkembangan
 1  (  
 ( (#  
( #   (  
    #  , 
'( 9 
 ( ( - 
3    
3 +   
3  4  
  1  (  (
Riwayat Imunisasi Dasar

# 3 &(


3/: (
' &(
  (
/ # ( (

  1        (


Riwayat Makanan
2 &  $"*!;&6 !#   $"* # 
      #  ( # 1 
&2   $"*    1 &(  
2   " # (  (    (! 
  !  1 ! 1 !   !&#  
"( 2 ( #    (  <   
# ## 1  #  ( 
 
< (   (     #    (
( =    1 !&(  !
  ! 2  (  "
(  (  
Riwayat Penyakit yang Pernah Diderita

'  2 '  2
m  2 ' 0  2
  #  2   2
 (   >    2
+  2 '    2
: + 2 ' 1#  2
)   2 m#  2
/ 4   2 4 (  2
$      >
2  2
Riwayat Keluarga

No. Tgl lahir Jenis Hidup Lahir Abortus Mati Ket.Kese


Kelami mati (sebab) hatan
n

 &2-2 ? > 2 2 2 2

 22 @ > 2 2 2 2
Data Keluarga
Ayah Ibu

Perkawinan ke-  

Umur saat & 8


menikah

Keadaan  (  (
kesehatan
PEMERIKSAAN FISIK
Tanggal : 24 Desember 2010 Jam : 10.00

PEMERIKSAAN UMUM
    # ( (  
   4# 
  5 
A (    6=
(    =9
A (  #  6=
"  &,!/

DATA ANTROPOMETRI
3    (
     4

( (#  84

(     -4
PEMERIKSAAN FISIK
PEMERIKSAAN SISTEMATIS
KEPALA
3 ( (   4#
   ( (#        !  ( 
 4 
 # # #    ( ! 
 (4(!(+ 5   (  !
4    (  !##   ( !
   &! 0 (4  1 >=>
   (  !     # !
 (  (  
  (  !  (  # 5  !
 (  (  !  (  #  #  4#  
   (  !    (( !  (
   !  ((      ! ( 
 1   !lidah kotor di bagian tengah, tepi
lidah hiperemis, tidak ada tremor lidah
 (  0   ( #  !    

  (    !( +     (   !
( +    !# 2 0 4 5 4  
4 5 4   (   
PEMERIKSAAN FISIK
THORAX
 
2 *#(  #  (      (    
   !  (   #   (    4  
#   
2  #   0  (  2(  # 2 (   
(
2  (   #  (  # #  # 2#  
*/"B*/
(
2 $(    #  #  5 (  ! ( 2=2 ! C 2=2

)  
2 *#(  ( (    ( # (
2  #   ( (         B ( 5 ( (
2  (   #! +  (    B  
 4 5 4   
(  #   
   **  
#      
2 $(  3)* **  !  2!: #2
PEMERIKSAAN FISIK
ABDOMEN
2 *#(  # (
2  #  hepar teraba 2 cm di bawah arcus
costae dextra, konsisitensi kenyal,
tepi tajam, permukaan licin, nyeri
tekan (+)!   (   ,
0 ( 2
2  (  #  ! 0 
 2!  >
2 $(    >  
PEMERIKSAAN FISIK
GENITALIA ?! ( 
ANUS REKTUM   ( # (
(    
EKSTREMITAS  (   !  (
  !  (  
 !  ( 
0  
KULIT     (!# 4 2
KGB    !4 5 4 !# 2
0 4 5 4 ! 6 !   
 (  
PEMERIKSAAN FISIK
PEMERIKSAAN NEUROLOGIS

Refleks Fisiologis
 4  >=>! 

  >=>! 
3 4# >=>! 
 4# >=>! 
Refleks Patologis
3  ( 2=2! 
/ 4( 2=2! 
m##  2=2! 
:  2=2! 
PEMERIKSAAN LABORATORIUM
Tanggal 24 Desember 2010
Pemeriksaan Hasil Nilai Normal

Hematologi
   &! =
!,28!8
 ( D &82,
  ,-=E 82

( &=E &2

Serologi Widal
"  1# m >=&
"  1#  2
"   1# $m 2
"   1# $ 2
"   1# 3m 2
"   1# 3 2
"   1# /m >=&
"   1# / 2
RESUME
è   # (    (   &
  (""  (  (  
       (1    
+ (,   (   ( ' 
  0  (       +  
 !     
è " #  #  (  2(   (   (
  (  (
è   +    #  6
4 !    !  (   !( 2(  1 (
=  F + (   (  
 ( 
è   +  3$33$#    
è   (  1  (   #  
(     (   
è    + +  (       
è   #1  1        #!
    #   1 
RESUME
è   #  0  (  # ( (    !
# ( (  ! (  4# 
è   5 
2 A (    6= !  !  4(#!   
(
2 (    =9
2 A (  #  6=
2 "  &,./
è   # (      # ( 
 1 (  #    # (   #  
#   #   /  #       
# (    # ( #  4
   44 ! #  + !# (  4 !
(   (1 ! 1  ( >
è   # (    #    5 
  # (   # 0#     "  1# 
m>=& "   1# /m>=&
RESUME
DIAGNOSA
"#'  0 
DIAGNOSA BANDING
2 'A
2 *"
2 3 ( 
2 *0 C
2 3# 
2 3 (#
PENATALAKSANAAN
      
'   (    (4(#(  !4(##   !   
/ 
§   (68=(33=     
688
" #  

   (6=(33=(
&6  
   (6!=(33=(
!  
     6 #+ 
RESUME
ANJURAN PEMERIKSAAN
    
  0
 (   ( #
 ( 0   6
  6
G   

PROGNOSA
$5   
$0    
$     
FOLLOW UP PASIEN
Ô   
  

" ' >! >!1 #  >! (>!# (2!


 ( (  3$3 3$ 4   
m % # ( (  
  /
 =,
  6=
"&9H/
#  &6=
 ( 0  ( 
#   4#
  /$2=2 "*2=2
   " 2=2
  "(  2=2
    "  2 I
   >
 ( A  #  2
    I 
J6   $(   I  Im2
 6 3)*2**>! 
GC2=2 I2=2
$3%  

    ' 
 &! = 
 D
  ,-

(  
"   1# m >=&
"   1#  2
"  # 1# /m>=&
FOLLOW UP PASIEN
Ô   
  

" ' >! >! 2! ( #  >! (>


(  2(  3$ 4 !  ( +  3$32
m % # ( (  
  /
 =,
  6=
"&,!,./
#  96=
 ( 0  ( 
#   4#
  /$2=2 "*2=2
   " 2=2
  "(  2=2
    "  2 I
   >
 ( A  #  2
    I 
J6   $(   I  Im2
 6 3)*2**>!  IGC2=2 I2=2
$3%   
FOLLOW UP PASIEN
Ô   
  
" ' 2! 2! 2! ((  2(  m
  (  #   3$ 4   1 (
3$32
m % # ( (  
  /
 =,
  -6=
"&,H/
#  &6=
 ( 0  ( 
#   4#
  /$2=2 "*2=2
   " 2=2
  "(  2=2
    "  2 I
   >
 ( A  #  2
    I 
J6   $(   I  Im2
 6 3)*2**>!  IGC2=2 I2=2
$3%  

    ' 
 !9 =
 D
  &

( 8
FOLLOW UP PASIEN
Ô   
  
" ' 2! 2! 2! ((  2(  m
  (  #   3$ 4   1 (
3$32
m % # ( (  
  /
 =,
  -6=
"&!8H/
#  6=
 ( 0  ( 
#   4#
  /$2=2 "*2=2
   " 2=2
  "(  2=2
    "  2 I
   >
 ( A  #  2
    I 
J6   $(   I  Im2
 6 3)*2**>!  IGC2=2 I2=2
$3%   
FOLLOW UP PASIEN
Ô   
  

" ' 2! 2! 2! ( ( 3$


4   1 (3$36(     (!  (  
    
m % # ( (   
  /
 =,
  -6=
"&H/
#  6=
 ( 0  ( 
#   4#
  /$2=2 "*2=2
   " 2=2
  "(  2=2
    "  2 I
   >
 ( A  #  2
    I 
J6   $(   I  Im2
 6 3)*2**>!  IGC2=2 I2=2
$3%   

    9' 
 &! =
 D
  &&

( ,
ANALISA KASUS
'  1# #    (  1  ( 
  (  1    (   #  
G #+ (     5  ! + 1 
    (   #      !
    #4  !&  (  
  ( (    #    #   
#  !  1  #  #     ( 
#    '  ( #      
 (   !1   4   2
 #   (  
  #       ((     1# 
# (# (  '    ((    ( 
$  
   , 1   ' +  
     #   1   #   # 
 ( #  #   1  ( 5 #    (
  
'      #4   #  
 ( # 
   + +  (          !
1   (+ (   1
ANALISA KASUS
  #    # ( 0  (1 
 ( 
'  # (   2  5   
  !(  1  !
#   (  
    #   ( (  #  
 1   #  #  #  1 !
 2
#  4   44 !
#  + !# (  4 !(   
(1 ! 1  ( >
ANALISA KASUS

 ( #+  (


 ((     1# 
#  (   
  ( #1   1# 
   ( (  # 
# #  !  !
 ! + !4   #
+     ( (    
   #  
# (  4 ('$( "
1#
ANALISA KASUS

è '    1#   ( ( 


 1     (!   0 (  ( 
 (  ( &28 
è 3 (  # 0#  2D( 1  # ( 
#   #   ( 
è 3 ( 0   ( # 0   #  
è 3 (     ( # 0#  #1 ( 
   + !  # ( # ( 1 # 
 0
è 3 (  # 0  (   1# !  # 
 (   0  (1 ( (   1# 
     ( (     (     
#   # 0 (  !   
2 +  1  
2 #    5    #
2 ( #   
ANALISA KASUS
  #    ( (( # ( (  
 (   (  ( 1 4(#
  (    1  # ( 
 4 ('$  ( (( (   1 1 
   0     ( 1    
  #     (( # (    
   # (   >#     "  
1# m "  # 1# /m 
=&
G #+    G   (+ 
    1#       ( 
  0 1   +  #  
% (  (    + (  (
 (( # ( (     
0
ANALISA KASUS

 (  #    1# !


   #  #     #   !
#   1   (1   4   
(   #   1 4(#    
  2   (     ((  0 ( 
 88# ( # 6   
# (  1 "    (   #  (
# 4  !    ( #  ! (#(  
:  : (   #  #  
   #  ( #   #    
 ( (    (  (     #  ( (  
 #    # + (  (       
  #!   (    (!  + (     (
 # 8   
J3$$"$

'J$*Am*'
Definisi

1 (  0(  ( #   


        (  
+    ,  
 !    #4  !
   (  
Batasan
* K 
-DK" 1#
  1 K"# 1#
-DK &< - 
+  L  8 
 #   ( (   ( 
#1 (   1
  ( '=# # ( 
 ( (  ((0  
Etiologi

´"   1#


´"  # 1# $
´"  # 1# 3
´"  # 1# /
Etiologi
"   1# 
 3    0
 3  (0 
   ( #
 #1 & 4   
è  m (! C (# (
##  (  
è  0  
è  B
 '  #  #C   
        
Etiologi
   (#  
#  &,4/84/24/
 A ( 0   
  # #   1 
 #
  #  8!/  +  
4/  8
 ' #    # # 
   !!! # 
(  # ( 
Etiologi
Salmonella paratyphi A, Salmonella
paratyphi B, dan Salmonella
paratyphi C

è + 1        


 1   (  
"   1#
è 3 ( ( K=  ( 
  
Epidemiologi

' *  # (  


 (
   (1 ( 
  1     8 
Patogenesis
 "  1#
M
 (  >  
M

 K — 

  
M
A (      
M
 # (    
M L
$     4  # (   4
M L
$  Bakteremia Primer  #  (  (
M L
J"   #  K$  Bakteremia Sekunder
Patogenesis
  (  ( (  ( +
#(   # (1
( (#  (  ( #   N
# 0  
:+    (  
 ( 
:+ #  #4  
  (  (  #
Patogenesis
   # F#1   i   
     

Fase 1  # #  0 (  0 

Fase 2 (  0 (  0    


(   ( (  (

Fase 3    #   ( # +   


 ((  # 0   #  

Fase 4 #1  +# (2 


 (1 (    (1  ( 
Gejala klinis
:+ (  #    (  1   
    (  
   (    
"     (  
:+ #     ( !   !
 ! !1 (# ! (
# ( 0!  4  
"     (  
' ! :  #4  !
  (  
Gejala klinis
' 
è step ladder temperature chart K  
  !(  (4   # #
 1  4 #  (   #
 *!     (   
  #   (2   
#  4   
è   0 febris remiten N ( # 

è "L =  !M#  
Gejala klinis
2. Gangguan saluran pencernaan
2  0     ( #
2 3  ( N#4 ragaden
2
   #  # # (  
coated tongue!+N # 1 
(  !+    
2   (meteorismus
2  N #    1 
( 
2  #  K#  (  4 (
2 ' K 1  
3. Gangguan kesadaran
2 (    # <  
2 + # !(    
:+ (  
:+  
2 roseola  4 ( ( # # #  
(   ! !#N
(  K *  # 
  ( 2&
2 Bradikardia relatif #    (
2 #  ( 
Relaps (kambuh)
    1 + #1 0
 #     N   (
  minggu II     
  K +  (     # 1 
     1  (# 
  (   (   #
 C  
( # #  minggu IV  ( 
#1  ( (K 5    
   # ( +  
0   
Komplikasi
% 
#   
2  ( KBenzidin test
2  1 (K 
2  K1 #  >   + 
# 0  
2   1  ( 
2 #    
2 #( (  
2     N 0 
Komplikasi
4#  
2  = # # 0  
2 +  (  
O 1 #  
O 0 4    
O 1  ( 
# (     
K(  (   #    (  # 
 (     !(   !
0 # !
Komplikasi
K(  0( ( 
 (#
K   N    (   ( 
 (  ( N# #   (  
  
K'*/!     (! 
  
K:   0 !#  0 ! 
# 0 
Diagnosis kerja
 # (    
# (  (1(  
# (   #
2 (#
2 0    0
2  0
2 
2  #   
# (   
2  # ( 0J"  1   ( 0 
2  # !  # !
# 7
Diagnosis kerja
 (   ( 
  
3 ( #
2   " 1# #  (  
 # * (
2 # 0  N0  ( 1

2  06     N
0 (  
N (+( 
Diagnosis kerja
G 
2   rx aglutinasi   
#  4 # # 
 " 1#
2 +  + 6    
2 4 (  !(  C 
 #   ( !1 
#4    1
  (  6    
Diagnosis kerja
& ( + 

 ( $ 
´' J*$' JC1*   
$ 1
´ 1 /  4 /
´*' # 4(  
Diagnosis kerja
    mP= 
+(( ( ( #   0
      ( # (  ('=
( #   #   # 
   =#     

 #G    (  + 
#   0
  
Diagnosis kerja
2  # + ( 
Q  mN  (    # 1 
     !(  0(   
/ #  
Q # !C     #  
  1   #
Q   #  0(   4(  
G A 6
Q (      4   ( 
 (1   #  = 0( 
(  
Diagnosis Banding
 0 $!3!/
*0 C

 (  
'
   
' 
Pengobatan
   # N 0( # ( 
N(( 
# 1 ( (
  ( (# (    
 ( 1  !  !  ( !
&       # 
  ( !1    
 (!      #   
" ( (N
 + 1    N + 
Pengobatan
'  
2  (    4(#4 !
(  N  #   
2 3   (   (  
 1 ( ! (  N (
  (  1 ( 
2 "(   #   ( 
2 % (# (  M (  4 
#   (  # #  
2 3   (  N 0 (  (# 
  (  (    (
Pengobatan
8m #  Kloramfenikol    
=(= !6 #=*=*B
K 0 2 ( # 
 #  (
2  #  ( +
K# (C   7(      4# 
  ( 
K# 1 # ( # 
   ( 5 (  #
m  ampisilin!kotrimoksazol!
Tiamfenikol, Amoksisilin, Seftriakson,
Sefiksim
Pengobatan
"/
2   0 4 'm/8< =
 !  *B    
  <  ! 
2 $(  =(= ! =
*B! 
2 "0 (29=(6 
  8
2   (   K# 0  

Pengobatan

3  #(# (       # 


1 
2    N     4 *B
2  (#    ( 
  !
Pencegahan
  #   N ( 
2 44     ( 
2 #1    
2 #   #    
0
*  
*    ( 0    
2 ( (#  0 
2 
3
2  1#  (  
 (
4  
*  
2 5 ( #  (  4 # B 
# 1 44 
K#  =  
K*
K   #& 
2 5 (  0  12 
K# ;    5  
  !&N8
K   #&< 8 
Prognosis
%1 #  #  ( (  
# 4#  
 ## 1 D
  (  (= ( +(  
 
#     # # ( =0 ( 
(  M# !( ! 
&(# (      N   !
#  ! (# !
 C  (     #