Laporan Harian Tgl 4 Agustus 2015
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LAPORAN HARIAN BOKS NEUROPEDIATRI 1 Agustus 2015 (Junior : dr. Ading ; Madya : dr. Renya; Senior : dr. Lidya, dr. Destiana) N O IDENTITAS DIAGNOSIS TATA LAKSANA PEMERIKSAAN LANJUTAN Keterangan H C U 2 M. Firza Alfarizi/ Lk/ 16-7-09 BB: 14 kg PB: 113 cm LK: 46 cm 905024 MRS: 30-7-2015 Penurunan kesadaran ec. Hipoksia DD/ Meningitis, Meningoensefalit is, Ensefalitis + edema paru RABER RESPIRO IVFD NaCl 0,9% gtt 12 x makro Ampisilin 3 x 500mg Gentamisin 2 x 40 mg Furosemide 2 x 15 mg Dexametasone 3 x 4mg Ceftriaxon 1x1,5gr(3) 31-7-15 LCS : 30-7-15: SGOT: 44 SGPT: 37 Albumin 4,7 Ureum: 38 As. Urat: 5,90 Creatinin: 0,41 Ca: 10,2 Mg: 2,18 Na: 139 K: 4,7 Cl: 104 FIO2 : 40 pH: 7,424 pCO2: 29,6 pO2: 109,4 Na+: 133,8 K+: 3,31 HCO3: 19,5 BEb: -3,2 1 Aden S/Lk/17-11- 2011 BB: 10kg PB: 50 cm BB/U <-3 PB/U -2 s/d 0 SD BB/PB : <-3 SD 15013462/903139 MRS 21-7-15 Penurunan Kesadaran ec. Meningitis TB O2 nasal 1L/menit D5 ¼ NS gtt 8x(makro)/menit Aminofusin 1g/kgBB/hr kec. 8cc/jam Ceftriaxone 1 x 1g (9) Fenitoin 2x50mg Paracetamol 4x 10ml Dexametasone 3x3mg STOP Nebu ventolin +NS/8jam Asetazolamid 3x150mg R/H/Z/E 150/100/350/200 21-7-15: Hb 11,6 WBC 19900 Ht 35 Plt 450.000 MCV 74,8 MCH 25 MCHC 33 LED 25 DC 0/0/84/8 ret: 1,0 BSS 124 Ureum 9 Cr 0,31 Ca 9,0 Na 144 K 4,1 CRP 6 22-7-15: LCS: tidak bewarna, agak keruh, tidak berbau, BJ 1.020 bekuan (-) LEUKOSIT 192 pmn 38 mn 63 nonne + pandy + protein 0,3 Glukosa 41,3 LDH 218 Cl 108 26-7-15: Mantoux test: (-) 27-7-15: Hb 15,1 Ht 42 WBC 12.200 Plt 179.000 DC: 0/0/89/7/4 SGOT 142 SGPT 170 Alb 3,4 Protein Total 6,4 ur 5 Cr 0,18 As. Urat 3,4 Ca 8,5 Na 136 K 3,3 Cl 102 24-7-17: Bilasan Lambung BTA I(-), BTA II (-) LK: 51 cm 3 . 6 Satria N A/ Lk/9- 11-14 BB: 7,1kg PB 84cm BB/U: PB/U: BB/PB: LK: 47 cm 15018935/903080 MRS: BP + Meningitis O2 nasal 1 l/m Ceftriaxone 1x 850 mg (13) Ampisilin 4 x 850 mg (13) Ca glukonas 5 cc dalam D5 50 cc (1jam)/8jam hari kedua O2 nasal 1 l/m 20-7-15: Hb 10,7 WBC 4.400 Ht 32 Plt 35 MCV 73,4 MCH 24 MCHC 33 LED 11 DC 0/0/55/26/19 Ret 0,9 AGD: FIO2 40% pH + 7.295 pCO2 48,7 pO2 39,5 SO2 57,2 Na+ 132,2 K+ 3,99 HCO3 22.9 BEb -3,0 SGOT 2232 SGPT 728 Protein total 8,1 Albumin 3,8 GDS 199 Ureum 102 Creatinin0,59 Ca 7,0 Na 136 K 5,3 Cl 108 LCS: tidak bewarna, agak keruh, tidak berbau BJ 1.020 bekuan (-) pH 9,0 Lekosit 385 PMN 77 MN 23 Sel blast (-) nonne (+) pandy (+) protein 0,1 LDH 146 Glukosa 142,2 Cl 124 22-7-15: Hb 7,3 WBC 10.400 Ht 21 Plt 62.000 MCV 73,1 MCH 25 MCHC 34 LED 2 DC 0/0/77/12/11 Fe 99 TIBC 211 Ferritin 442,4 Ur 24 As. Urat 3,8 Ca 7,8 Phospor 4 Na 140 K 3,4 Cl 105 LK: 44 cm 1
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Transcript of Laporan Harian Tgl 4 Agustus 2015
LAPORAN HARIAN BOKS NEUROPEDIATRI1 Agustus 2015 (Junior : dr. Ading ; Madya : dr.Renya; Senior : dr. Lidya, dr. Destiana)N
!D"N#!#AS D!A$NS!S #A#A LA%SANA &"M"R!%SAAN LANJ'#AN %eterangan()'2M. *ir+a A,-ari+i. L/. 101210344: 15 /g &4: 116 78L%: 50 78305025MRS: 601212015&enurunan /esadaran e7. (i9o/sia DD. Meningitis, Meningoense-a,itis,"nse-a,itis : ede8a 9aruRA4"R R"S&!R!;*D Na), 0,3< gtt 12 = 8a/roA89isi,in 6 = 5008g$enta8isin 2 = 50 8g*urose8ide 2 = 15 8gDe=a8etasone 6 = 58g )e-tria=on 1=1,5gr(6)6112115 L)S : 6012115: S$#: 55 S$: 62 A,>u8in 5,2 'reu8: 6? As. 'rat: 5,30 )reatinin: 0,51 )a: 10,2 Mg: 2,1? Na: 163 %: 5,2 ),: 105*!2 : 50 9(: 2,525 9)2: 23,0 92: 103,5 Na:: 166,? %:: 6,61 ()6: 13,5 4">: 16,21 Aden S.L/.121111201144: 10/g &4: 50 7844.' @16 &4.' 12 s.d 0 SD44.&4 : @16 SD15016502.306163MRS 2112115&enurunan %esadarane7. Meningitis #42 nasa, 1L.8enitD5 A NS gtt ?=(8a/ro).8enitA8ino-usin 1g./g44.Br /e7. ?77.Ca8)e-tria=one 1 = 1g (3)*enitoin 2=508g&ara7eta8o, 5= 108,De=a8etasone 6=68g S#&Ne>u Dento,in :NS.?Ca8Aseta+o,a8id 6=1508gR.(.E." 150.100.650.2002112115: (> 11,0 F4) 13300 (t 65 &,t 550.000 M); 25,? M)( 25 M)() 66 L"D 25 D) 0.0.?5.? ret: 1,0 4SS 125 'reu8 3 )r 0,61 )a 3,0 Na 155 % 5,1 )R& 02212115: L)S: tida/ >eGarna, aga/ /eruB, tida/ >er>au, 4J 1.020 >e/uan (1) L"'%S!#132 98n 6? 8n 06 nonne : 9andy : 9rotein 0,6 $,u/osa 51,6 LD( 21? ), 10?2012115: Mantou= test: (1)2212115: (> 15,1 (t 52 F4) 12.200 &,t 123.000 D): 0.0.?3.2.5 S$# 152 S$ 120 A,> 6,5 &rotein #ota, 0,5 ur 5 )r 0,1? As. 'rat 6,5 )a ?,5 Na 160 % 6,6 ), 1022512112: 4i,asan La8>ung 4#A !(1), 4#A !! (1)L%: 51 786.0Satria N A. L/.311111544: 2,1/g &4 ?57844.':&4.':44.&4:L%: 52 781501?365.3060?0MRS: 4& : Meningitis 2 nasa, 1 ,.8)e-tria=one 1= ?50 8g (16)A89isi,in 5 = ?50 8g (16))a g,u/onas 5 77 da,a8 D5 50 77 (1Ca8).?Ca8 Bari /edua2 nasa, 1 ,.8)e-tria=one 1= ?50 8g (10)A89isi,in 5 = ?50 8g (10)*enitoin 2 = 55 8gEin7 1 = 20 8g Dia ngt)a g,u/onas 5 77 da,a8 D5 50 77 (1Ca8).?Ca82012115: (> 10,2 F4) 5.500 (t 62 &,t 65 M); 26,5 M)( 25 M)() 66 L"D 11 D) 0.0.55.20.13 Ret 0,3 A$D: *!2 50< 9( : 2.235 9)2 5?,2 92 63,5 S2 52,2 Na: 162,2 %: 6,33 ()6 22.3 4"> 16,0 S$# 2262 S$ 22? &rotein tota, ?,1 A,>u8in 6,? $DS 133 'reu8 102 )reatinin0,53 )a 2,0 Na 160 % 5,6 ), 10?L)S: tida/ >eGarna, aga/ /eruB, tida/ >er>au 4J 1.020 >e/uan (1) 9( 3,0 Le/osit 6?5 &MN 22 MN 26 Se, >,ast (1) nonne (:) 9andy (:) 9rotein 0,1 LD( 150 $,u/osa 152,2 ), 1252212115: (> 2,6 F4) 10.500 (t 21 &,t 02.000 M); 26,1 M)( 25 M)() 65 L"D 2 D) 0.0.22.12.11 *e 33 #!4) 211 *erritin 552,5 'r 25 As. 'rat 6,? )a 2,? &Bos9or 5 Na 150 % 6,5 ), 105$D# 8i/rositi/ Bi9o/ro8 dengan tro8>osito9eniaA$D: *!2 50< 9( 2,520 9)2 52,2 &2 50,2 S2 00,3 Na: 160 %: 2,53 ()6 61,6 4"> 0,? %u,tur 'rine: steri,2012115: (> 2,? F4) 10.000 (t 25 &L# 210000 D) 0.0.00.20.20 A,> 6,1 ), ?,6 Na 162 % 6,? ), 102L%: 55 781 5.2RatiB A8a,ia.&r.20121201544: 0 /g &4:00 7844.': 11,02&4.' :144.&4:12,25L/: 56 78 (nor8o7e9Ba,i)306??5.15013525MRS: 2512115&enurunan %esadarane7. Meningitis >a/teria,is : (e8angio8a R. -ronta,isA89isi,in 6=5008g (11))e-tria=one 6= 008g (11)Dia+e9a8 >i,a /eCangNe>u ;ento,in: NS. ? Ca82 nasa, 2L.8enitA89isi,in 6=5008g (0))e-tria=one 6= 008g (0)De=a8etasone 6 = 2 8g (0)Ranitidine 2 = 108gDia+e9a8 >i,a /eCang2512115: (> 11,5 F4) 5.500 (t 66 &,t 00.000 M); 26,5 M)( 25 M)() 65 L"D 2 D) 0.5.00.20.10 S$# 2225 S$ 2262 &rotein tota, 5,3 A,> 6,1 4SS ?1 'r 25 As.'rat 0,5 )r 0,65 )a 2,3 Na 156 % 5,5 ), 113 )R& @5 L)S: /e/uningan, CerniB, tida/ >er>au, 4J 1.020 9( 3 ,eu 605 &MN ?2 MN1? Nonne H 9andy : 9rot 0,1 LD( 560 $,u/ 02,0 ), 116""$ >rain 8onitoring (21?115)L%: 52 785.69i7uM. Su,ton Atta8a8i.L/.211121201644: 3,5 /g&4: 23 7844.': 11,52&4.': 11,0244.&4: 10,35L%: 5078301036.MRS: 0510212015Meningitis 4a/teria,is : 4&2 sung/u9 5L.8D12,5 /e7 6077.Ca8*100 ?= 10077$,isero, 6=2077Mero9ene8 6=2008g (20)S#&Ne>u ;ento,in : NS.? Ca8A>>oti7 (7,aritro8y7in)512115: (> 10,5 F4) 3200 (t 62 &L# 112.000 M); 25,5 M)() 66 L"D 65 D) 0.0.0?.25.? 4SS 00 Na 150 % 50 ), 116 )a 00 )R& 55 L)S tida/ >erGarna, CerniB, tida/ >er>au, 4J 1020 >e/uan H 9( 3 ,eu/osit 30 &MN 20 MN 25 se, >,ast H nonne H 9andy : 9rotein 0,1 LD( 50 $,u/osa 21,2 ), 162 212115: : (> 10,5 F4) 2000 (t 62 &L# 25?.000 M); 25,5 M)() 66 L"D 65 D) 0.0.20.1?.0 S$# 132 S$ 152 A,> 6,0 4ss 10? 102 'r 65 )r0,23 )a 3,1 &Bos-or 6,5 Na 156 % 5,1 ), 1162012115: (> 16,6 (t 50 F4) 16,6 &,t 505.000 M); ?1,1 M)( 22 M)() 65 L"D 1? D) 0.0.50.65.15 )a 10,0 Na 155 % 5,1 ), 116L%: 52 785.5MarGaB. &r. 1tB 3 >,n44 0,? /g &4: 26 7844.':15,10 &4: 16,?044.&4: 12,35L%: 50 78R! 1501050?. ?33022MRS 2110115Meningitis 4a/teria,is Ra>er gi+i dan in-e/siA# (!N( 258g. Ri-a89isin 25 8g. &EA 1508g. "ta8>uto, 258g) (12)(a,o9erido, 2=0,02 (10)A89isi,in su,>a7ta8 6 = 650 8g (?)A8i/asin (11) ren7ana >eso/ ganti 7otri8o=sa+o,e ora,4e7,o-en 6= 1,2 gr&rednison I1 I 1 I (2)R. Jsiotera9i(> 11,0 F4) 5.000 (t 62 &,t 155.000 L"D 2 D) 0.0.00.60.10 $DS 120 )a ?,6 Na 16? % 2,02510115 )a 2,2 Na 163 % 5,0 L)S tida/ >erGarna, CerniB, 4J 1,020 >e/uan (1) 9( ? Leu 05 &MN ?? MN 12 Nonne (1) &andy (:) &rot 0,1 LD( 66 $,u/ 35,0 ), 1222510115 Na: 160 %: 5 ),: 106 )a:2,32210115 )a ?,? Na 160 % 6,0 ), 102?12115: (>: 3,? Leu/osit ?.000 (t 60 L"D 22 D): 0.5.0?.20.2%u,tur daraB : Steri,312115: /u,tur urine: 7andidiasis a,>i7ans (yeast(:)9seudoBy9a(:)) K100.000.8,312115: >i,asan ,a8>ung 4#A ! (1) 1012115:L)S: tida/ >erGarna, CerniB, tida/ >er>au, 4J 1.020 4e/uan (1) 9( ?,0 ,e/osit 21 &MN ?2 MN 1? Se, >,ast (1) nonne (1) 9andy (:) 9rotein 0,1 $,u/osa 25,3 LD( 50 ), 161 L)S: 4#A (1) >i,asan ,a8>ung 4#A !! (1)1012115: kultur LCS: S. Epidermidis, Sesiti! "#$k%m&'i, Amik$'i(1612115: >i,asan ,a8>ung !!! (1)1512115: (> ?,0 F4) 3.200 (t 25 &,t 56?.000 M); 2? M)( 22 M)() 65 L"D 62 D) 0.1.00.25.2 Ret 1,5 S$# 05 S$ 56 'reu8 3 L%: 55 782!;*D D5 A NS gtt 0=.8 !nC. ;an7o8y7in 6 = 150 8g &ara7eta8o, 5 = 1 7tB*,u7ona+o,e 1=558g (15) S#&A# (!N( 258g. Ri-a89isin 25 8g. &EA 1508g. "ta8>uto, 258g)4S4 6 = 60 77*25 ?= 60 77*isiotera9i!nC. A7y7,oDir 6 = 208g (12)S#&!nC. De=a8etason 6= 28g (5) sto9!nC. A89i7i,,in 6= 2008g (10 sto9)A8ino steri, 0< /e7. 5,277.Ca8(a,o9erido, 2=0,02 (2)A89isi,in su,>a7ta8 6 = 650 8g (6)$enta8isin 2 = 15 8g (2)Metronida+o,2 = 50 8g (2))reatinin 0,22 As urat 1,? )a ?,2 Na 16? % 6,2L.$D#: ane8ia Mi/rositi/ nor8o/ro8, anisositosis, -rag8entosit (:) se, target (:) (> e,e/tro-oresa, 7e/ status >esi,8onitor daraB te9i 10102115:(> ?,2 F4) ?.000 (t 25 &,t 566.000 L"D 55 D) 0.6.53.61.2 4i,. #ota, 0,22 4i,. Dire/ 0,12 4i, !ndire/ 0,15 S$# 155 S$ ?1 A,> 6,6$,o 2,5 ureu8 5 as. 'rat 1,6 )reatinin 0,1? )a ?,1 Na 163% 2,? ), 112 &Bos-or 6,1 )R& @52512115: (> 3,2 F4) 2.500 (t 22 &,t 555.000 M); ?2 M)( 2? M)() 65 L"D 3 D) 0.1.02.21.11 S$# 65 S$ 02 'reu8 21 As 'rat 5.2 )r 0,25 )a ?,6 Na 162 % 6,1 ), 101%u,tur 'rine: Steri,2612115: %u,tur A>ses : S."9ider8idis5.5"ri/ Sya>an.L/.21011544: 5,0 /g 305322.1501333?MRS: 6012115 &enurunan /esadaran e7. Sus9. &ening/atan #!% e7. SA( : Bidro7e9Ba,us (Dentri/u,o8ega,i) : ane8ia e7. Sus9. &erdaraBan DD. de-. *e !;*D D5 A NS 20=8i/roR. 9erasi e,e/ti-R. trans-usi &R) 1M?08g 5.0(er,i >in As8aGi.L/.111021201544:0 /g&4: 05 7844.' 12,13&4.' 11,3044.&4: 11,32L%: 50 78 (nor8o7e9Ba,i)1501350?.306305Mrs: 2512115%eCang de8a8 e7. Meningitis >a/teria,is : ane8ia : Bidro7e,e: Bernia u8>i,i7a,is!D-d. D5 A Ns gtt 0=.8nt 8a/roA89i7i,in 6 = 000 8g (5))e-tria=one 1 = 000 8g(5)De=a8etBasone 6 = 2 8g(5)2512115: L)S: tida/ >eGarna, aga/ /eruB, tida/ >er>au, 4J 1.020 >e/uan (:) 9( ?.0 Le/osit 5?2 &MN 52 MN 5? Nonne (1) &andy (:) &rotein0,1 LD( 0,22 $,u/osa 63,5 ), 1652212115: (> 11 F4) 15.500 (t 65 &,t 655.000 D) 0.0.?0.16.1L%: 52 785.1Ai/o A,Daro.L/.601121201544: 0,3 /g&4: 05 7844.': 11,02 &4.': 12,23Meningitis 4a/teria,is 2 nasa, 1L.8enit!;*DA89isi,in 6 = 200 8g (5))e-tria=one 1 = 200 8g(5)De=a8etasone 6 = 28g(5)Dia+e9a8 28g >i,a /eCang2212115: (> 11,2 (t 66 F4) 2.200 &,t 5?.000 D) 0.1.66.00.0 $DS 102 S$# 100? S$ 130 'reu8 13 )reatinin 0,20 )a 2,? Na 116 % 5,? ), 100L)S:/e/uningan, aga/ /eruB, tida/ >er>au, 4J 1.020 >e/uan (1) 9( 3,0 Le/osit106 &MN 03 MN 61 nonne (:) 9andy (:) &rotein 0,1 LD( 2? $,u/osa 102,5 ), 1152?12115: (> 3,5 (t 22 &,t 26.000 F4) 5.500L%: 51 78644.&4: 10,22L%: 52 78(nor8o7e9Ba,i)15013002.305052MRS: 221212015'S$ A>do8en :e-usi 9,eura de=tra 8ini8a, : asites :2312115: (> ?,2 (t 25 F4) 0.100 &,t 61.000 D) 0.0.22.55.13 2312115: (> 3,5 (t 2? &,t ?6.000 F4) 12.200 D) 0.0.66.52.15 )a ?,0 Na 160 % 5,2 ), 3,56012115: (>: ?,5 (t 25 &,t 02.0005.25.6M. *ransis/o.L/. 2011011644: 11/g &4: ?0 78L%: 55 7815015152.3051?6MRS: 611112015 %eCang tan9a de8a8 e7. Sus9. SLdd. "9i,e9si !;*D D51.5 NS gtt. 10=(8a/ro).8enit4i,a /eCang *enitoin 2008g 2 = 508g2 nasa, 2 L.8enitR. )# s7an %e9a,a 6112115: (> 12,5 F4) 10,? (t 6? &,t 63?.000 D) 0.1.05.62.6 4SS 165 )a ?,? Na 152 % 5,1 5.5M. NoDriansyaB. L/.1011110?44: 1? /g &4 112 78L%: 51,5 78305212.15020131MRS: 11?12015 %D% : tonsi,o-aringitis A/ut A8o/sisi,in 6 = 250 8g&)# 6= 2508g >i,a K 6?,5 7Dia+e9a8 6 = 58g 5.5Mi=da, Reder. &r. 22112116BB : ),* k+ PB: ,* 'm L%: 5?78 557844.'N12,15&4.'N10.2244.&4N12,5215015605. ?32125MRS 0310115Meningitis #4 : 4&&neu8onia ,o>aris (D)2 nasa, 1 L. 8enit*,u7ona+o,e 1=1208g 4a7,o-en 6=28g 9.o;ento,in:NS Ne>u 6= 1a89De=a8etasone 6=6 8g(sto9)),aritro8i7yn 2=1008gR.(.E." : 150.?0.600.100 (10)4S4 6M100*100 ?M008,2 nasa, 1 L. 8enit*,u7ona+o,e 1=1208g 4a7,o-en 6=28g 9.o;ento,in:NS Ne>u 6= 1a89De=a8etasone 6=6 8g(sto9)A+itro8isin 1 =150 8gR.(.E." : 150.?0.600.100 (2)212115 /u,tur daraB steri,1010115 L)S tida/ >erGarna, aga/ /eruB, 4J 1,01 >e/uan (1) 9( ?,0 Leu 600 &MN 0? MN 62 Nonne (1) &andy (:) &rot 0 $,u/osa 05,3 LD( 00 ), 160%u,tur urine: steri,1210115 (> 11,1 F4) 16.000 (t 25 &,t 202.000 L"D 100 D) 0.0.22.11.12 S$# 260 S$ 1? A,> 6,2 'r 2 As.'rat 6,0 )r 0,13 Na 155 % 5,2 ), 110 )R& 03 1310115 (> 12,5 F4) 50.500 (t 6? &,t 521.000 L"D 11 D) 0.0.?2.?.5 S$#150 S$ 21 &rot.#ota, 0,1 A,> 6,0 $,> 2,5 'r 6 As.'rat 2,6 )r 0,20 )a 3,2 Na 151 % 5,0 )R& 1062510115 S$# 15? S$ 25 A,> 6,5 'r 10 )r 0,25 As.'rat 2,3 )a 3,0 Na 151% 6,5 ), 32?12115 : (>: 13,? Leu/o: 3,6 (t: 61 #ro8>osit: 202L"D: 60 D): 0.0.56.66.1? 'reu8: 12 as.urat:2,0 )reatinin: 0,21 )a:3,1 Na: 152%: 5,6 ),: 105 )R&: 011212115: #es 8antou= (1)1612115: (> 3,? F4) 2.000 (t 60 &,t 605.000 M); 22.2 M)( 25 M)() 66 L"D 65 D) 0.1.21.25.5 Reti/u,osit: 1.5 S$# 250 S$ 22 'reu8 10 As.'rat 1,30 /reatinin 0,134i,asan La8>ung 4#A ! (1), 4#A !!(1)1012115: B> 3,5 F4) 2.200 (t 60 &,t 2?0.000 L"D 66 D) 0.2.22.52.13 'r 12 )r 0,1? As urat 2,6 )R& 2602212115: (> 3,? F4) 60.000 (t 62 &,t 1.15?.000 M); 25 M)( 26 M)() 61 L"D 25 D) 0.0.0?.20.11 S$# 122 S$ 22? 'r 12 As.urat 5,2 )r 0.26 )a 3,1 Na 156 % 5,6 ), 105 )R& 11? 221215: (> 10,5 (t 65 F4) 21.200 &,t 000.000 M); 2?,5 M)( 61 M)() 61L"D 52 D) 0.0.25.12.? Ret: 6,2 S$# 202 S$ 135 &rotein tota, 2.5 A,> 6,2 ur 20 )r 0,26 As. 'rat 12,2 )a 3,0 Na 150 % 0,2 ), 1106012115: )a 3,1 Na 163 % 6,5L%: 55 7855.0!.2 LAN#A! 6 A>iyyu dania, $Baisan.L/.?151201544: 5,5 /g&4: 06,5 78L%: 52,5 78305130.15015102MRS: 6112115 &enurunan %esadaran e7. Meningitis 4a/teria,is !;*D D5 A NS gtt. 25 =.8i/ro)e-ota=i8e 6 = 5008g;an7o8y7in 5 = 25 8gDe=a8etasone 6 = 2 8g&7t 5 = 0 77Diet *100 0 = 100 77 (Soya)2 nasa, 1 L.8enit6112115: (> 12,5 F4) 3.600 (t 60 &,t 102.000 L"D ? D) 0.1.52.63.16 Na 162 % 5,5 ), 105 )R& 11L)S: tida/ >eGarna CerniB, tida/ >er>au 4J 1.020 9( ? >e/uan (1) ,e/osit 212 &MN 23 MN 21se, >,ast (1) nonne (1) 9andy (:) 9rotein 60 LD( ?6 $,u/osa 05,? ), 120 &anCi Nau-a, A, 4Badri/a.L/.2210?11644: ?,5/g &4: 2?7844.': 16,01&4.': 12,3344.&4: 12,12L%: 6? 78 (8i/rose-a,i)15013552.306?35%eCang tan9a de8a8e7. Sus9 "9i,e9si : $DD : 8untaB &ro-useS#&&"RDe9a/ene 2 = 2,5 77'rda-a,/ 6=?08g),ona+e9a8 2=0,05 8g (6)R. Jsiotera9i2512115: (> 16,1 F4) 11.600 (t 62 &,t 35.000 M); ?2,6 M)( 61 M)() 65 Led 0 D) 0.2.11.26.15 S$# 03 S$ 1? )a 3,5 Na 15?% 5,6 5MRS: 251212015M. *ari+ A+Bari. ,/. 10>,n15010512. ?55523?,6/g. 2078. 5178MRS 2110115(idrose-a,us &ost ;& sBunt : )& : sus9. "9i,e9si : /eratitis e/s9osureDS : atro9i 9a9i, >i,atera,!nC. )e-tria=on 1= 3008g (15)S#&!nC. A89i7i,in 6= 3008g (15)S#&Aseta+o,a8id 6= 008g&yrido=in 6= 58gLa8eson 6= 18g)ar>a8a+e9in 6 = 508g 9.o.Susu 12=25 77&)# 6 = 1008g*,o=a 1 gtt DS.Ca8;iga8o= 1gtt DS.Ca8As -usidat 7r 2=sueManito,6 = 2077)e-ota=i8e 2=1008g(6)4a,an7e 7airan.0Ca82110115 (> 10,5 G>7 15.000 (t 62 &,t 000.000 L"D 12 D) 0.1.02.60.2 $DS 112 )a 3,3 Na 152 % 5,62?10115 (> 12 F4) 26.200 (t 6? &,t 200.000 L"D 12 D) 0.0.52.60.16 )R& 15212115: 'rina,isis: d>n?12115: (>: 3,2 Leu/o: 5,100 (t: 60#ro8>o: 510.000 L"D: 56 D): 0.0.23.51.20 'r: 15 As.urat: 2,10 )r: 0,1? )a: ?,1 Na: 160 %: 5,0 ),: 103 )R& @56010115: /u,tur daraB steri,612115: /u,tur urine steri,1012115: 4i,asan La8>ung 4#A !(1), 4#A !! (1) 4#A !!! (1)2212115: B> 10.3 Bt 65 9,t 032.000 F4) 11.000 M); 26,1 M)( 26 M)() 61L"D 52 D) 0.1.5?.50.11 S$# 52 S$ 55 'R 15 )r 0,10 As.urat 2,1 )a ?,? Na 156 % 5.2 ), 1122212115: (> 3.? F4) 12.?00 (t 61 &,t 523.000 D) 0.1.26.13.2 S$# 61 S$ 62 &rotein tota, 5,2 A,> 6.6 'r 5 )r 0,22 As.urat 2,2 )a ?,2 Na 152 % 6,52612115: /u,tur urine: %,e>sie,,a 9neu8oniae( S: a8i/a7in, )B,ora89Beni7o,, -os-o8y7in)L%: 52 78 02
