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TABLE OF CONTENTS.

TABLE OF CONTENTS ------------------------------------------------ 1

CHAPTER 1 (INTRODUCTION) ------------------------------------- 2

CHAPTER 2 (FRAME OF THEORY) -------------------------------- 3-6

CHAPTER 3 (SUMMARY) -------------------------------------------- 7


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CHAPTER 1

INTRODUCTION

Indonesia is a country where the spread of tropical diseases like dengue

fever still high in this country.

Dengue fever disease was first discovered in Indonesia in Surabaya in

1968, but gained new virological confirmation in 1972.

Asia ranks first in the number of patients with dengue fever each year.

This may be caused by the rainfall in Asia is very high, especially in east

Asia and south combined with environmental sanitation is not good.

WHO estimates more than 500,000 of 50 million cases of dengue fever

requiring hospitalization. More than 40% of world population living inendemic areas affected by this disease.

Hemoragic Dengue fever is a disease caused by dengue virus belonging

to group B arthropod, dengue virus is transmitted through the bite of

mosquitoes of the genus Aedes (Aedes aegypti, Aedes albopictus, and

Aedes polynesiensis). Many contracted dengue fever in the tropics and

subtropics.


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2.4 Risk factor :

- Banyak jentik nyamuk di rumah nya,

- tetangga/serumah ada yang terkena dengue hemoragic fever

- tidak pernah dilakukan pengasapan di rumah nya.

- keadaan rumah yang kurang terurus,,

- kurang nya edukasi,

2.5 Clinic picture :

- Fever for three days continuously (cyclic fever)

- fever-free phase (crisis phase)

- muscle pain

- hepatomegali (liver enlargement)

- freckle spots on skin (peteki)

- anemia

2.6 Patofisiologi :

1.) (Pathophysiology of dengue hemoragic fever causes plasma leakage)

Aedes mosquito bites that contain dengue virus viremia (sudden

fever, headache, nausea, muscle pain, aches throughout the body,

decreased appetite, abdominal pain and red spots on skin)

anafilaktosin release substances, histamine, and serotonin,

hipertermi if the system activity accompanied

kolikrein increased permeability of capillary wall / vascular


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so that fluid from the intravascular out into ekstravaskular

occur plasma enlargement due to its shortage in the

intravascular plasma volume there will be hypovolemia, hypotension,

hemokonsentrasi, hipoproteinemia and shock.

2.) (Patofisiologi DHF menyebabkan anemia)

Aedes mosquito bites that contain dengue virus excretion of saliva, which

contains anti-coagulant (anti-clotting agents) that facilitate the entry and spread

of dengue virus it decreases the blood clotting process

if there is bleeding anemia

2.7 Diagnose :

Based on clinical symptoms and physical examination and laboratory

examination then we will know his diagnosis of this disease eg only on

clinical symptoms of fever was found there three days later continuous

physical examination hepatomegaly was found there and on examination

found there in his lab thrombocytopenia

2.8 Diagnose deferensial :

- typhoid fever

- hepatitis

- influenza

- yellow fever


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2.9 handling :

In DHF patients we did five protocol handling

Protocol 1: adult protocols without shock

Someone who is in his best guess suffer dbd monitored kept in hospital.

Protocol 2 : fluid administration in patients with DHF

1500+(20x(BB dalam kg -20) = .. ml

Protocol 3 : management of DHF with increased hematocrit> 20%

Protocol 4 : management of spontaneous bleeding in adult DHF

Protocol 5 : treatment of dengue shock syndrome in adults

2.10 Prognosa

If you've passed the critical phase (phase-free fever), then the prognosis

would be good, continue to monitor the patient's condition and fluid

intake do not overdo it.


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