SARI PUSTAKA

RICKETTSIA

Disusun oleh :
Emanuela Eka M. DJ. Ulukyanan
2265050151
Pembimbing :
dr. Achnes Pangaribuan, M.Biomed, Sp.PD

KEPANITERAAN KLINIK ILMU PENYAKIT DALAM

PERIODE 7 AGUSTUS – 14 OKTOBER 2023
UNIVERSITAS KRISTEN INDONESIA
FAKULTAS KEDOKTERAN
JAKARTA
2023
 DAFTAR ISI

BAB I BAB II BAB III

PENDAHULUAN TINJAUAN PUSTAKA KESIMPULAN

 BAB I
PENDAHULUAN
 PENDAHULUAN

1. Rickettsia merupakan bakteri gram negatif, non-motil.

2. Terdiri dari empat kelompok ancestral, kelompok typhus , kelompok transitional, dan kelompok spotted fever
3. 01
Vektor penularnya dari hewan arthropoda seperti pinjal, kutu, caplak, dan tungau
4. Rickettsioses -> penyakit demam akut
5. Diagnosis klinis rickettsioses sulit dilakukan, bergantung pada petunjuk epidemiologis

Pramestuti N, Widiastuti D, Lestari E, Sari I. Z. R, Apriliana S. Rickettsioses : Penyakit Tular Vektor yang Terabaikan. Kemenkes. 2022
Blanton L. S, The Rickettsioses : A Practical Update. NCBI. 2019; 33(1):213-2
Warrell C E, Osborne J, Nabarro J, Gibney B, Carter D. P, Warner J, Ett all. Imported Rickettsial Infection to the United Kingdom, 2015-2020. Journal Of Infection. 2023; 86:446-452.29
Showden J, Ladd M, King K. C. Rickettsial Infection. NCBI. 2023
 BAB II
TINJAUAN PUSTAKA
 DEFINISI
1. Rickettsioses adalah penyakit zoonosis yang disebabkan oleh bakteri dari Genus Rickettsia
dan Orientia.
2. Masa inkubasi -> 6 dan 14 hari
3. Gejala demam, mialgia, sakit kepala, batuk kering, ruam yang menyebar.

Pramestuti N, Widiastuti D, Lestari E, Sari I. Z. R, Apriliana S. Rickettsioses : Penyakit Tular Vektor yang Terabaikan. Kemenkes. 2022
Warrell C E, Osborne J, Nabarro J, Gibney B, Carter D. P, Warner J, Ett all. Imported Rickettsial Infection to the United Kingdom, 2015-2020. Journal Of Infection. 2023; 86:446-452.29
 EPIDEMIOLOGI

1. Musim semi dan musim panas -> Rocky Mountain spotted

fever (>90% kasus) di Amerika Serikat
2. Sumatra (Aceh), dan Sumatra Timur -> scrub typhus dan
mites fever
3. Jawa -> scrub typhus dan mites fever

Pramestuti N, Widiastuti D, Lestari E, Sari I. Z. R, Apriliana S. Rickettsioses : Penyakit Tular Vektor yang Terabaikan. Kemenkes. 2022
Inamar A.C, Palit A. Rickettsial Disease. BLDE University. 2019
 ETIOLOGI
1. Ancestral (Rickettsia bellii, Rickettsia canadensis)
2. Typhus (Rickettsia prowazekii Rickettsia typhi)
3. Transitional (Ricketsia akari, Rickettsia felis), dan
4. Spotted fever groups (Rickettsia ricketsii, Rickettsia conorii,
Rickettsia sibirica)

Showden J, Ladd M, King K. C. Rickettsial Infection. NCBI. 2023

Ilman A. B, Hanifa R. Tinjauan Atas Murinne Typus. CDK. 2020; 47(2).
H. G, H. L, L.C, S. Brazilian Spotted Fever : A Reemergent Zoonosis. J Venom. Anim. Toxins incl. Trop. Dis. 2008;14(1)
Pramestuti N, Widiastuti D, Lestari E, Sari I. Z. R, Apriliana S. Rickettsioses : Penyakit Tular Vektor yang Terabaikan. Kemenkes. 2022
 PATOGENESIS RICKETTSIA

H. D, Walker. Rickettsiae. NCBI.

Walker d. H. Rickettsiae Medical Microbiology. NCBI.1996

 MANIFESTASI KLINIK
KU Jenis Ruam Organ Yang Terlibat

Spotted Fever Group demam, sakit kepala, dan pergelangan tangan dan pergelangan 1. KGB -> limfadenopati
Rickettsioses mialgia kaki sebelum muncul secara terpusat 2. Pulmo -> Batuk, sesak
pada batang tubuh 3. Neuro -> kejang

Typus demam yang tiba-tiba, sakit Neuro -> kejang

kepala dan mialgia

Transitional Group lesi papulovesikuler.

Rickettsioses Tambahan -> demam, sakit
kepala, dan mialgia

Pramestuti N, Widiastuti D, Lestari E, Sari I. Z. R, Apriliana S. Rickettsioses : Penyakit Tular Vektor yang Terabaikan. Kemenkes. 2022
Blanton L. S, The Rickettsioses : A Practical Update. NCBI. 2019; 33(1):213-2
Showden J, Ladd M, King K. C. Rickettsial Infection. NCBI. 2023
 PENEGAKAN DIAGNOSIS

1. Pemeriksaan Lab darah : Leukositosis, trombositopenia, LED, hipoalbuminemia

2. Uji Weil Felix : Antibodi yang menggumpal, terutama IgM, dapat dideteksi 5-10 hari setelah timbulnya
gejala
3. Uji imunofluoresensi Assay (IFA) : merupakan gold standar -> tes Ig G
4. Enzyme-linked immunosorbent assay (ELISA) : IgM atau IgG untuk infeksi rickettsial SFG dan TG

Inamar A.C, Palit A. Rickettsial Disease. BLDE University. 2019

Stewart A. G, Stewart A. G. A. An Update on the Laboratory Diagnosis of Rickettsia spp.Infection. NCBI. 2021; 10(10)
 TATALAKSANA
1. Doksisiklin 100 mg- 200 mg
2. Kloramfenikol -> bila ada alergi
3. Rifampisin 300-450 mg 2x1 selama 7 hari
4. Azitromisin 500 mg -> ibu hamil

03
Showden J, Ladd M, King K. C. Rickettsial Infection. NCBI. 2023
Premaratna R. Rickettsial Ilnesses, a leading cause of acute febrile illness. CME: Tropical Medicine. 2022; 22(1):2-5
 PENCEGAHAN

1. Mengenakan baju lengan panjang, celana panjang, kaus kaki, dan sepatu berujung tertutup
2. Penggunaan pengusir serangga seperti N diethyl 3-methylbenzamide (DEET)
3. Penggunaan permethrin pada tempat tidur,
4. Serta pemeriksaan terhadap serangga setelah beraktivitas di luar ruangan dapat meminimalkan
infeksi rickettsial

Premaratna R. Rickettsial Ilnesses, a leading cause of acute febrile illness. CME: Tropical Medicine. 2022; 22(1):2-5
 BAB III
KESIMPULAN
 KESIMPULAN

1. Rickettsioses adalah penyakit zoonosis yang disebabkan oleh bakteri dari Genus Rickettsia dan Orientia
2. Rickettsia dapat dikelompokkan dalam empat kategori: ancestral (Rickettsia bellii, Rickettsia canadensis),
typhus (Rickettsia prowazekii Rickettsia typhi), transitional (Ricketsia akari, Rickettsia felis), dan spotted fever
groups (Rickettsia ricketsii, Rickettsia conorii, Rickettsia sibirica)
3. Pemeriksaan IFA dianggap sebagai pemeriksaan ‘gold standar’' untuk diagnosis infeksi rickettsial -> test Ig G
4. Pengobatan tidak boleh ditunda
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 DAFTAR PUSTAKA
1. Pramestuti N, Widiastuti D, Lestari E, Sari I. Z. R, Apriliana S. Rickettsioses : Penyakit Tular Vektor yang
Terabaikan. Kemenkes. 2022.
2. Blanton L. S, The Rickettsioses : A Practical Update. NCBI. 2019; 33(1):213-229.
3. Warrell C E, Osborne J, Nabarro J, Gibney B, Carter D. P, Warner J, Ett all. Imported Rickettsial Infection to the
United Kingdom, 2015-2020. Journal Of Infection. 2023; 86:446-452.
4. Showden J, Ladd M, King K. C. Rickettsial Infection. NCBI. 2023.
5. Inamar A.C, Palit A. Rickettsial Disease. BLDE University. 2019.
6. Ilman A. B, Hanifa R. Tinjauan Atas Murinne Typus. CDK. 2020; 47(2).
7. Stewart A. G, Stewart A. G. A. An Update on the Laboratory Diagnosis of Rickettsia spp.Infection. NCBI. 2021;
10(10).
8. Premaratna R. Rickettsial Ilnesses, a leading cause of acute febrile illness. CME: Tropical Medicine. 2022;
22(1):2-5.
9. H. G, H. L, L.C, S. Brazilian Spotted Fever : A Reemergent Zoonosis. J Venom. Anim. Toxins incl. Trop. Dis.
2008;14(1).
 Review of Systems

Neptune Saturn
Neptune is the Saturn is composed

01 farthest planet from

the Sun 02 mostly of hydrogen
and helium

Mercury Jupiter Mars

Mercury is the This gas giant is the Despite being red,

03 smallest planet in
our Solar System 04 biggest planet in our
Solar System 05 Mars is actually a
cold place
Results
Mercury is the closest planet to the Sun and
the smallest one in the Solar System—it’s
only a bit larger than our Moon. The planet’s
name has nothing to do with the liquid metal,
since it was named after the Roman
messenger god
 02
Discussion
You could enter a subtitle here if you need it
Discussions

“Neptune is the farthest planet from the Sun

and the fourth-largest in our Solar System’’ Dr. John Doe

“Venus has a beautiful name and is the second

planet from the Sun. It’s terribly hot’’ Dr. Jenna James

“Mercury is the closest planet to the Sun and Dr. Daniel

the smallest one in our Solar System’’
Patterson
Discussions Summary

01
Venus has a beautiful name and is the second
planet from the Sun. It’s terribly hot and its
atmosphere is extremely poisonous

02
Jupiter is a gas giant and the biggest planet in our
Solar System. It’s also the fourth-brightest object
in the sky

03
Mercury is the closest planet to the Sun and also
the smallest one in our Solar System. It’s only a
bit larger than our Moon
 03
Diagnosis
You could enter a subtitle here if you need it
 Diagnosis
Neptune Mercury
Neptune is the fourth-largest Mercury is the closest planet to
planet by diameter in our Solar the Sun and the smallest one in
System our Solar System

Saturn Mars
Saturn is the ringed one. It’s a Despite being red, Mars is
gas giant, composed mostly of actually a cold place. It’s full of
hydrogen and helium iron oxide dust

Venus Jupiter
Venus has a beautiful name and It’s the fourth-brightest object in
is the second planet from the the sky and the biggest planet in
Sun. It’s terribly hot our Solar System
 Comparison

01 02 03 04
Saturn

Venus

Jupiter

Pluto
 04
Treatment
You could enter a subtitle here if you need it
 Treatment
Mars is full of iron oxide
Week 1 dust, which gives the planet
its reddish cast

Saturn is the ringed one. It’s

a gas giant, composed of
hydrogen and helium
Week 2

Venus has a beautiful name

Week 3 and is the second planet
from the Sun

Jupiter is a gas giant and the

biggest planet in our Solar
System
Week 4
A Picture
Always
Reinforces the
Concept
A Picture Is
Worth a
Thousand
Words
05
Patient Monitoring
You could enter a subtitle here if you need it
 Patient Monitoring
Week 1 Week 2
To change the size of the graph, click the circle and drag the colored handle
Venus has a beautiful name and is the
second planet from the Sun
Venu Satur
Mars Pluto
Venus s n

Mars

Saturn Week 3
Mercury is the
Venu Satu
Marss rn
closest planet to the
Pluto Sun Plut
o
 Contraindications - Indications
Saturn is the ringed one. It’s a Despite being red, Mars is
gas giant, composed of actually a cold place. It’s full
hydrogen and helium of iron oxide dust

Jupiter is a gas giant and the

Neptune is the fourth-largest
fourth-brightest object in the
planet in our Solar System
sky

Venus has a beautiful name Pluto is in the Kuiper belt and

and is the second planet from is considered a dwarf planet
the Sun since 2006

Mercury is the closest planet Ceres is a dwarf planet and

to the Sun and the smallest in the biggest object in the
our Solar System asteroid belt
 Post-prevention

Jupiter is a gas giant and

the biggest planet in our
Jupiter Mercury Mercury is the smallest
planet in our Solar
Solar System System

Venus is terribly hot and

its atmosphere is
Venus Mars Despite being red, Mars
is actually a cold place
extremely poisonous

Neptune is the fourth-

largest planet in our
Neptune Saturn It’s a gas giant,
composed mostly of
Solar System hydrogen and helium
 Case Timeline

Phase 1 Phase 2 Phase 3 Phase 4

Neptune is the fourth- Saturn is the ringed one. Venus has a beautiful name Mars is full of iron oxide
largest planet in our Solar It’s a gas giant, composed and is the second planet dust, which gives the planet
System of hydrogen and helium from the Sun its reddish cast
 Conclusions
Mercury is the closest planet to the Sun
and the smallest one in the Solar
System—it’s only a bit larger than our
Moon. The planet’s name has nothing to
do with the liquid metal, since it was
named after the Roman messenger god,
Mercury
 References

● AUTHOR (YEAR). Title of the publication. Publisher

● AUTHOR (YEAR). Title of the publication. Publisher

● AUTHOR (YEAR). Title of the publication. Publisher

● AUTHOR (YEAR). Title of the publication. Publisher

● AUTHOR (YEAR). Title of the publication. Publisher

● AUTHOR (YEAR). Title of the publication. Publisher

 Our Team

Helena James John Doe Jenna

Here you can talk a bit Here you can talk a bit Patterson
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