PRESENTASI KASUS

Otitis Eksterna Difusa dengan Otomikosis

Disusun Oleh :
Putri Pitaloka G4A020055
Arifatul Ulumiyah G4A020057
Annisa Mardianti S. G4A020059
Yusrina Nika Amalia G4A020137
Pembimbing:
dr. Wahyu Dwi Kusdaryanto, Sp. THT-KL

DEPARTEMEN ILMU PENYAKIT THT-KL

RSUD PROF DR MARGONO SOEKARJO
FAKULTAS KEDOKTERAN
UNIVERSITAS JENDERAL SOEDIRMAN
2021
Identitas Pasien

Nama Ny. K

Usia -

Jenis Kelamin Perempuan

Pekerjaan Ibu Rumah Tangga

Alamat -

Tgl Periksa 19 Agustus 2021

No. CM 00943344
Anamnesis
Riwayat penyakit sekarang :
Pasien datang dengan keluhan suara bergemuruh disertai pegal pada telinga kiri sejak 1 minggu
yang lalu berlangsung 1 hari kemudian hilang sendiri kemudian menjadi suara dengung dan berdenyut
yang tidak membaik. Keluhan dirasa memberat hingga mengganggu tidur dan aktivitas sejak 3 hari yang
lalu tanpa diketahui sebabnya. Skala nyeri 7/10. keluhan penyerta yang dirasakan antara lain telinga
terasa penuh, nyeri jika disentuh dan menjalar hingga ke kepala bagian kiri.

Keluhan Utama : Tinitus bergemuruh sejak 1 minggu yang lalu memberat sejak 3
hari yang lalu
Onset : Sejak 1 minggu
Lokasi : Telinga kiri
Kualitas : Mengganggu tidur dan aktivitas
Kuantitas : Skala nyeri 7/10
Faktor memperingan dan memperberat: -
Keluhan penyerta : Telinga terasa penuh, nyeri jika disentuh dan menjalar hingga ke
kepala bagian kiri
Anamnesis
Riwayat penyakit dahulu :
- 2015 ; Retensi plasenta dengan tindakan histerektomi supravaginal
- 2015 ; Tekanan darah meningkat sejak histerektomi tanpa pengobatan
- 2017 ; Oklusi tuba dan impacted cerumen dengan terapi Tremenza

Riwayat penyakit keluarga :

-

Riwayat sosial ekonomi :

- Ibu rumah tangga
- Hubungan keluarga baik
- Stressor dirasa cukup berat akhir-akhir ini
- Menggunakan BPJS non PBI
Pemeriksaan Fisik
KU/Kes : Sedang, CM Pemeriksaan thorax
Tanda Vital
Dinding : Gerak simetris, retraksi (-)
Tekanan Darah : 130/84 mmHg
Nadi : 85 x/menit Paru : SD Vesikuler +/+, RBK (-), RBH (-),
Respirasi : 18 x/menit
Wheezing (-)
Suhu : 36.7 C
BB : 81 kg Jantung : S1>S2, gallop (-), murmur (-)
TB : :157 cm
Pemeriksaan abdomen
Datar, distensi (-), BU (+) normal, timpani
Kepala : Mesosephal
seluruh kuadran, NT (-)
Rambut : Distribusi rata, warna hitam
Hepar/lien : Tidak teraba
Mata : CA -/-, SI -/-, pupil bulat Isokor
Punggung : Deformitas (-)
3mm/3mm, RC +/+
Pemeriksaan ekstremitas
Mulut : Sianosis (-), basah (+)
Akral hangat (+/+//+/+), CRT < 2 detik
Leher : Pembesaran KGB (-)
Pemeriksaan Fisik

Auris Dextra Auris Sinistra

Aurikula Normotia, tragus pain (-) Normotia, tragus pain (+)

Nyeri tekan (-), benjolan (-),

Preaurikula Nyeri tekan (-), benjolan (-), edema (-)
edema (-)
Nyeri tekan (-), benjolan (-),
Retroaurikula Nyeri tekan (-), benjolan (-), edema (-)
edema (-)
Mukosa edem (-), hiperemis (-), MUKOSA EDEM (+), HIPEREMIS (+),
MAE serumen (-), discharge (-), massa serumen (-), DISCHARGE (+), massa (-),
(-), furunkel (-) furunkel (-)
Intak, reflek cahaya (+) di
Intak, REFLEK CAHAYA (-), hiperemis (-),
Membran Timpani anteroinferior, hiperemis (-),
discharge (-)
discharge (-)
Pemeriksaan Fisik

Dextra Sinistra

Mukosa Hiperemis (-) Hiperemis (-) Lidah Tremor (-), kotor (-)

Discharge (-) (-) Uvula Deviasi (-)

Konka media & T1/T1, hiperemis (-), detritus

Edema (-) Edema (-) Tonsil
inferior (-), kripte tidak melebar

Hiperemis (-), gramulasi (-),

Septum Deviasi (-) Deviasi (-) Faring
pos nasal drip (-), massa (-)

Massa (-) (-) Mukosa Lembab, hiperemis (-)

Pemeriksaan Penunjang

OTOENDOSKOPI
CAE AS tampak discharge keputihan

AS post AS pre
Diagnosis

Diagnosis Kerja Diagnosis Banding

Otitis Eksterna Difusa -
Otomikosis
 Tatalaksana

Medikamentosa Non Medikamentosa

- Cetrizine 10mg tab 1x1 PO - Irigasi

- Ketokonazole 200mg tab 1x1 PO
- Otopain eardrop 3x4 gtt AS

Edukasi

• Edukasi mengenai penyakit, faktor risiko, pengobatan dan prognosis.

• Pasien disiplin dalam menggunakan obat yang diberikan secara teratur.
• Pasien tidak mengkorek-korek tellinga dengan cotton bud atau benda asing lainnya.
• Pasien kontrol di poli THT sesuai dengan jadwal untuk mengontrol ada tidaknya perubahan setelah
pengobatan.
Prognosis

Ad bonam Ad bonam Ad bonam

Ad Vitam Ad Sanationam Ad Functionam
TINJAUAN PUSTAKA
-V11-
Pendahuluan

SATURN
Saturn is the ringed
one and a gas giant

MARS
Despite being red,
Mars is a cold place

MERCURY
It’s the closest planet to
the Sun
Anatomi Telinga (Moore, 2014)
Definisi Otitis Media Difusa Otomikosis
-
Etiologi OED dengan Otomikosis

MERCURY VENUS MARS

Mercury is the closest Venus has a beautiful Despite being red, Mars
planet to the Sun name, but it’s very hot is a cold place

JUPITER SATURN NEPTUNE

It’s the biggest planet in Saturn is the ringed one It’s the farthest planet
the Solar System and a gas giant from the Sun
Patofisiologi OED dengan Otomikosis
Diagnosis OED dengan Otomikosis
Anamnesis
OEDsensasi panas terbakar
dalam liang telinga, diikuti nyeri
saat menggerakkan mandibula.
Otomikosispruritus Pemeriksaan Penunjang
OED: Pemeriksaan radiologis  jika dicurigai
adanya necrotizing (malignant) OE atau
Pemeriksaan Fisik mastoiditis
OEDnyeri tekan, otorrhea, pewarnaan gram dan kulturdapat membantu
CHL, pembesaran KGB(pada jika pasien mengalami immunocompromised, jika
kasus berat), krusta pengobatan yang biasa tidak efektif, atau jika
Otomikosisterlihatnya hifa penyebab jamur dicurigai.
halus dan spora, Pada Candida: Otomikosis: Kultur jamur jarang dibutuhkan dan
tampak miselia berwarna putih tidak mengubah pemberian terapi.
dan jika bercampur dengan
serumen menjadi kekuningan
Tatalaksana

Medikamentosa Non Medikamentosa

Edukasi
Komplikasi

MARS SATURN
Despite being red, Saturn is the ringed
Mars is cold one

MERCURY VENUS
It’s the closest planet Venus has a beautiful
to the Sun name
Kesimpulan
● Dalam menegakkan diagnosis otitis eksterna biasanya anamnesis dan pemeriksaan fisik pasien
sudah memberikan informasi yang cukup. Pemeriksaan penunjang seperti pewarnaan gram dan
kultur cairan dari saluran pendengaran dapat membantu jika pasien mengalami
immunocompromised, jika pengobatan yang biasa tidak efektif, atau jika penyebab jamur
dicurigai. Kemudian pada otomikosis gejala yang hampir sering terjadi adalah pruritus, pada
otoscopy sering ditemukan miselia, dan adapun kultur jamur jarang dibutuhkan dan tidak
mengubah pemberian terapi.
Daftar Pustaka
THEMIC HEALTH
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01 02

MERCURY VENUS
Mercury is the closest planet It has a beautiful name, but
to the Sun is terribly hot

03 04

MARS JUPITER
Despite being red, it is It’s the biggest planet in the
actually a cold place Solar System
 WHOA!
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DIVIDE THE CONTENT

01 02

MERCURY
Mercury is the closest planet to the
Sun and the smallest one in the Solar
System and a bit larger than the
Moon
VENUS
Venus has a beautiful name and is the
second planet from the Sun. It’s a
terribly hot place, even hotter than
Mercury
YOU COULD USE
THREE COLUMNS,
WHY NOT?

MARS JUPITER VENUS

Did you know Mars is It’s a gas giant, and the It has a beautiful name,
actually a cold place full biggest planet of them all but also high
of iron oxide dust? temperatures
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A PICTURE IS
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USE A GRAPH TO SHOW YOUR DATA

MERCURY
Mercury is the closest
planet to the Sun

VENUS
It has a beautiful name,
but is very hot

To modify this graph, click on it, follow the link, change the data and
paste the new graph here, replacing this one
USE A GRAPH TO SHOW YOUR DATA

20%
Despite being red, it’s
actually a cold place

80%
Mercury is the closest
planet to the Sun

To modify this graph, click on it, follow

the link, change the data and paste the
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SOMETIMES, REVIEWING CONCEPTS IS A
GOOD IDEA

MERCURY VENUS MARS

Mercury is the closest Venus has a beautiful Despite being red, Mars
planet to the Sun name, but it’s very hot is a cold place

JUPITER SATURN NEPTUNE

It’s the biggest planet in Saturn is the ringed one It’s the farthest planet
the Solar System and a gas giant from the Sun
WHAT ABOUT FOUR COLUMNS?

MARS MERCURY
Mars is actually a cold place full Mercury is the smallest one in the
of iron oxide dust Solar System

JUPITER VENUS
It’s a gas giant, and the biggest It has a beautiful name and the 2nd
planet of them all planet from the Sun
OR THREE COLUMNS?

01 02 03

MARS JUPITER VENUS

Despite being red, Mars is Jupiter is actually a gas giant, Venus has a beautiful name
actually a cold place full of and also the biggest planet of and is the second planet from
iron oxide dust them all the Sun
INFOGRAPHICS MAKE YOUR IDEA
UNDERSTANDABLE

MARS SATURN
Despite being red, Saturn is the ringed
Mars is cold one

MERCURY VENUS
It’s the closest planet Venus has a beautiful
to the Sun name
 02

MEDICAL STAFF
You could enter a subtitle here if
you need it
MEDICAL BREAKTHROUGHS
OF THE DECADE

MARS MERCURY
Mars is actually a cold Mercury is in fact the
place and is full of iron smallest planet in the
oxide dust Solar System

JUPITER VENUS
It’s a gas giant and the It has a beautiful name
biggest planet in the Solar and the 2nd planet from
System the Sun
 THIS TEXT SEEMS
TO BE IMPORTANT...
Mercury is the closest planet to the Sun and the
smallest one in the Solar System—it’s only a bit
larger than the Moon
THIS IS A TABLE!

MASS DIAMETER GRAVITY

Mercury 0.06 0.38 0.38

Mars 0.11 0.53 0.38

Saturn 95.2 9.4 1.16

THIS IS A MAP

SATURN
Saturn is the ringed
one and a gas giant

MARS
Despite being red,
Mars is a cold place

MERCURY
It’s the closest planet to
the Sun
A DEDICATED TEAM

DOCTOR DOCTOR
DANNY DIANE
Here you could Here you could
talk a bit about talk a bit about
this person this person
A TIMELINE ALWAYS WORKS WELL

01 02 03 04

MARS MERCURY SATURN VENUS

Despite being red, Mercury is the Saturn is the ringed Venus has a
Mars is actually a closest planet to the one and it’s a gas beautiful name, but
cold place Sun giant terribly hot
 SATURN
2015 Saturn is the ringed one and
it’s a gas giant

MARS
2017 Despite being red, Mars is
actually a cold place
OR TRY THIS
TIMELINE VENUS
2020 Venus has a beautiful name,
but terribly hot

MERCURY
2023 Mercury is the closest planet
to the Sun
7,498,300
Big numbers catch your audience’s attention
HERE ARE SOME PERCENTAGES

37% 59% 85%

JUPITER SATURN VENUS

It’s the biggest planet in the Saturn is the ringed one and Venus has a beautiful name,
Solar System a gas giant but it’s very hot
 386,000 km
is the distance between Earth
and the Moon

333,000.00 24h 37m 23s

times of earths is the Sun’s is the total of Jupiter’s
mass rotation period
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one and a gas giant

MOBILE WEB MARS

You can replace the image on the 02 Despite being red,
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MERCURY
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