Laporan Kasus Panjang Dengue Syok Sindrom

8/10/2019 Laporan Kasus Panjang Dengue Syok Sindrom

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LAPORAN KASUS PANJANGoleh

wayan erawan

DENGUE HAEMORRHAGIC FEVER Gr. III

Pem !m !n" #Dr. Jo$e M. Man%e!& S'.A(K)


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PENDAHULUAN

DENGUEHAEMORRAG

IC FEVER

*!r+$ DENGUE "en+$

Fla*!*!r+$& ,am!l! Flaviviridae, $ero-!'e DEN /& DEN 0& DEN 1%an DEN2Indoneisa # (-hn 0334)

/53.333 6a$+$. An"6a

6ema-!an -elah men%e6a-! /7.SULUT (-hn 03//) : /2856a$+$.

Demam 0 4 har!& %!a-he$!$ (+9!-orn!:+e- 'o$!-!,)& 'e-e6!e&

e'!-a6$!$& %an hema-eme$!$. ;hrom o$!-o'en!a ??L& 6e o@oran 'la$ma

;!%a6 a%a 'en"o a-an $'e$! 6

hanya S!m'-oma-!6& S+'or-!,


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LAPORAN KASUS

Nama : A.LJenis Kelamin : Laki-laki

Tanggal Lahir /Umur : 31 Maret 2006 / /12tahun!i : !i "umah #i$an##L : 3.%00 gr Ke&angsaan : 'n$(nesia

Agama : Kristen )r(testan*uku #angsa : Minahasa


4/44

ANAMNESIS Anamne$!$ %! er!6an oleh # I +

'en%er!-a


5/44


6/44


7/44

Anamnesis An!ena!al Selama ham!l ! + 'en%er!-a

mela6+6an 'emer!6$aan 6eham!lan%! P+$6e$ma$ -er%e6a- -era-+r 8 6al!%! '+$6e$ma$ %an men%a'a-!m+n!$a$! ;; 0=. Selama ham!l ! +'en%er!-a $eha-.


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Pen"a#i! "an$ Suda Pe%naDialami

Mor !l! # ( ) Var!@ella # ( )

Per-+$!$ # ( ) D!are # ( ) Ca@!n" # ( )

a-+6?'!le6 # ( )


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Ke&andaian'Kema(uan )a"i

Per-ama 6al! mem al!6 # 1 +lan Per-ama 6al! -en"6+ra' # 2 +lan Per-ama 6al! %+%+6 # B +lan

Per-ama 6al! meran"6a6 # 8 +lan Per-ama 6al! er%!r! # /3 +lan Per-ama 6al! er9alan # /2 +lan Per-ama 6al! -er-awa # 1 +lan Per-ama 6al! er@elo-eh # 8 +lan Per-ama 6al! meman""!l mama# 8 +lan Per-ama 6al! meman""!l 'a'a # 8 +lan


10/44

Anamnesis Ma#anan ASI # Lah!r / -ah+n PASI #

+ +r $+$+ # 2 +lan 4 -ah+n + +r $ar!n" # + +r l+na6 #

Na$! lem e6 # / -ah+n 1-ah+n


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Imunisasi

DASAR

I II III

#+,

) L'

!T)

+AM)AK

)AT'T'* #


12/44

Ri*a"a! #elua%$aHanya 'en%er!-a yan" $a6!- $e'er-! !n! %alam

6el+ar"a.

Keadaan Sosial+ E#onomi+ Ke,iasaan danLin$#un$anR+mah 'ermanen& era-a' $en"& er%!%!n"'a'an& lan-a! -ehel& -er%!r! %ar! 0 +ah6amar -!%+r& %!h+n! oleh 0 oran" %ewa$a %an1 oran" ana6 ana6. Kamar man%! %an C%!l+ar r+mah& $+m er a!r m!n+m %ar! $+m+r&$+m er 'eneran"an l!$-r!6 PLN %an'enan"anan $am'ah %! a6ar.


13/44

PEMERIKSAAN FISIK Um+r # 8 8?/0 -ah+n # 00 6" ; # /05 @m Kea%aan +m+m # ;am'a6 $a6!- era- Kea%aan men-al # Com'o$ men-!$

S!ano$!$ # ( ) I6-er+$ # ( ) Ke9an" # ( ) Vi!al Si$n ;en$! # /33?43 mmH"

Na%! # /03 ?men!- re"+ler& -!%a6 6+a- an"6a- Re$'!ra$! # 02 ?men!- S+h+ # 1B&3 C


14/44


15/44

Ke&ala

en-+6 # me$o@e'hal$ U +n + +n e$ar men+-+' Ram +- # h!-am& -!%a6 m+%ah %!@a +- Ma-a # E=o'-alm+$ # ( ) ;e6anan ola ma-a # normal 'a%a 'era aan Kon9+n"-!*a # anem!$ ( ) S6lera # !6-er!6 ( ) Kornea re e6$ # normal P+'!l # +la-& !$o6or& 1mm?1mm& re e6$ @ahaya ( ) Len$a # 9ern!h F+n%+$ # -!%a6 %! e*al+a$! V!$+$ # -!%a6 %! e*al+a$! Gera6an # normal ;el!n"a # $e6re- ( ) H!%+n" # $e6re- ( ) M+l+- ! !r # $!ano$!$ ( )

M+l+-! !r # $!ano$!$ ( )Sela'+- m+l+-# a$ahL!%ah # 6o-or ( )G!"! # 6ar!e$ ( )G+$! # 'er%arahan ( )a+ 'erna'a$an # ,oe-oer ( )

;en""oro6an ;on$!l # ; / ; / h!'erem!$ ( )Far!n" # h!'erem!$ ( )Leher

;ra6ea # le-a6 %! -en"ahKelen9ar # 'em e$aran KG ( )Ka6+ 6+%+6 # ( )


16/44

T o%a- en-+6 # normal Ra@h!-!$ Ro$ary # ( ) R+an" In-er@o$-al # normal Pre@or%!al +l"!n" # ( ) !'ho$-ern+m # ( )

Harr!$on $ "roo*e # ( ) Perna'a$an 'ara%o6$al # ( ) Re-ra6$! # ( )Pa%u.&a%u In$'e6$! # $!me-r!$& re-ra6$! ( ) Pal'a$! # $-em ,rem!-+$ 6anan 6!r! Pal'a$! # $onor 6anan 6!r! A+$6+l-a$! #S'. ron6o*e$!6+ler&

Rhon6!( )&

heQ!n" ( )

/an!un$ De-a6 Jan-+n" # /03 ?men!- I6-+$ #

-!%a6 -am'a6

a-a$ 6!r! #l!nea m!%@la*!@+lar!$ $!n!$-ra

a-a$ 6anan #

l!nea 'ara$-ernal!$ %e=-ra a-a$ a-a$ # ICS II III +ny! 9an-+n" a'e= # M / M 0 +ny! 9an-+n" aor-a# A / A 0 +ny! 9an-+n" '+lmo # P / P 0 !$!n" # ( )


17/44

A,domen

en-+6 # %a-ar& lema$ U ( ) Normal L!en # -!%a6 -era a He'ar # 1 1 @m awah ar@+$ @o$-a Geni!alia # 0+ normal An$$o!a $e%a# # a6ral %!n"!n& CR; 0T Tulan$ ,elulan$ # %e,orm!-a$ ( ) O!o!.o!o! # e+-ro Re1e-.%e1e- # RF ?& RP ?


18/44


19/44

DIAGNOSIS D!a"no$!$ $emen-ara # DHF "r.III

%en"an -era'! $yo6 D!a"no$!$ an%!n" # Syo6 $e'-!6


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TERAPI Perawa-an?'en"o a-an # O 0 / 0 l?m IVFD RL 03 @@?6" ? 9am 223 @@ (0=) ( ol+$ 13 men!-) %! lan9+-6an %en"an IVFD "elo,+$!n /3 @@?6" ?9am 003

@@?9am

In9e6$! @e,o-a=!m 1 = 453 m" IV (/) Dom'er!%on 1 = / @-h (6?') alan$ D!+re$!$ ? 9am PCV ? 2 9am. O $er*a$! *!-al $!"n? 13 men!-. GDS r+-!n

An9+ran Pemer!6$aan# Darah len"6a'& D! Co+n-& Na& K& Cl&SGO;& SGP;& Ure+m& Crea-!n!n& I" M& I" G& an-! %en"+e&AP;;&P;& D %!mer& C rea@-!*e 'ro-e!n (CRP)


21/44

FOLLO UP Pe%a*a!an Ha%i Ke 2 3 45 desem,e% 67389 (am 35 77 4IRIA9 S# Demam ( )& $e$a6 ( )& 'en+r+nan 6e$a%aran ( )& $a6!- 'er+- ( )& +r!ne ( ). O # Kea%aan +m+m # ;am'a6 $a6!- Ke$a%aran # @om'o$ men-!$ ;an%a *!-al # ;e6anan %arah# /33?43 mmH" Na%! # //3 =?men!- Re$'!ra$!# 02 =?men!- S+h+ a%an # 1B&8 oC Ke'ala # Kon9+n"-!*a anem!$ ( )& $6lera !6-er!6 ( )& PCH ( ) ! !r S!ano$!$ ( ) Leher # Pem e$aran KG ( )

;hora= # S!me-r!$& re-ra6$! ( ) Cor # ( ) P+lmo# S+ara 'erna'a$an ron6o*e$!6+ler& Rhon6! ? & wheeQ!n" ? A %omen # Da-ar& lema$& !$!n" +$+$ ( ) normal He'ar # 1 1 @m L!en # -!%a6 -era a E=-rem!-a$ # A6ral %!n"!n& CR; 0T oe%em -+n"6a! ( ) A : DHF $% III den$an s"o# dalam !e%a&i P# O 0 $+n"6+' / 0 L?m IVFD RL 03 ml?6" ?9am lan9+- "an-! Gelo,+!n /3 ml?6" ?9am 003 @@?9am ($elama 13 men!-) In9. Ce,o-a=!m 1 = 453 m" IV (H/) D!+re$!$ 'er 9am PCV ?2 9am ;an%a -an%a *!-al 'er 9am Pa$an" 6a-e-er


22/44


23/44

;ANDA VI;ALJam T! mm g Na$i

/m" *uhu Urine

44!iuresis )+5 '57! "l

44//Kg/8am

13.00 100/90 120 2 36;6 41 20

1 .00 100/90 110 2 36; 10 gel(


24/44

FOLLO UPPe%a*a!an Ha%i Ke.6 4!an$$al 8 desem,e% 67389 S # Demam ( )& 6a6! -an"an %!n"!n ( )& m+n-ah ( )& nyer!

'er+- ( )& Ur!ne ( ). O# Kea%aan +m+m # ;am'a6 $a6!- Ke$a%aran # @om'o$ men-!$ ;an%a *!-al # ;e6anan %arah # /33?B3mmH" Na%! # >3=?men!- Re$'!ra$! # 13 =?men!- S+h+ a%an # 1B&8 oC Ke'ala# Kon9+n"-!*a anem!$ ( )& $6lera !6-er!6 ( )& PCH ( ) ! !r $!ano$!$ ( ) Leher # Pem e$aran KG ( ) ;hora= # S!me-r!$& re-ra6$! ( ) Cor # m+rm+r ( ) P+lmo# S+ara 'erna'a$an ron6o*e$!6+ler& Rhon6! ? &

wheeQ!n" ? A %omen # Da-ar& lema$& !$!n" +$+$ ( ) normal He'ar # 1 1@m awah ar@+$ @o$-a. L!en# -!%a6 -era a E=-rem!-a$ # A6ral han"a-& CR; 0T& A # DHF "r. III %alam -era'! /8 9am

P #

O0 / 0 L?m (6?')

IVFD RL 1

@@?6" ?9am BB ml?9am.

In9. Ce,o-a=!me 1=453 m" IV

(H0) Dom'er!%one 1 = / @-h (6?')

Oral!- a% l! !-+m

PCV ? 2 9am

D!+re$!$ ? 9amAn9+ran # DL& D! @o+n-&

'ro-e!n -o-al& al +m!n.


25/44

FOLLO UPPe%a*a!an Ha%i Ke.5 4 ; desem,e% 67389 S # Demam ( )& 6a6! -an"an %!n"!n ( )& m+n-ah ( ) O # Kea%aan +m+m # ;am'a6 $a6!- Ke$a%aran # Com'o$ men-!$ ;an%a *!-al#

;e6anan %arah # /33?B3 mmH"& Na%! # 8B=?men!-Re$'!ra$! # 12 =?men!- S+h+ a%an# 14&/ oC

Ke'ala?SSP # '+'!l +la- !$o6or 1mm 1mm& RC ?

&RF ? & RP ? & $'a$-!6 ( )&!6-er+$ ( ). Kon9+n"-!*aanem!$ ( )& $6lera !6-er!6 ( )& PCH ( )& ! !r $!ano$!$( )

Leher # Pem e$aran KG ( ) ;hora= # S!me-r!$& re-ra6$! ( )

Cor # m+rm+r ( ) P+lmo # S+ara 'erna'a$an

ron6o*e$!6+ler& Rhon6!wheeQ!n" ? A %omen # Da-ar& lema$& !$!n" +$+$ ( ) normal

He'ar # 1 1 @m a@ & L!en# -!%a6 -era a E=-rem!-a$ # A6ral han"a-& CR; 0T&A # DHF "r. III %en"an $yo6& %alam

-era'! 20 9am

P #

O0 / 0 L?m (6?') IVFD RL 8 "--?men!-- In9. Ce,o-a=!me 1=453 m" IV

(H1)- Dom'er!%one 1 = / @-h- oral!- a% l! !-+m PCV ? B 9am %!+re$!$ ? B 9amAn9+ran # DL& D! @o+n-Pro # '!n%ah r+an"an ;ro'!6


26/44

FOLLO UPPe%a*a!an Ha%i Ke.8 4 < desem,e% 67389 S # Demam ( )& 6a6! -an"an %!n"!n ( )& m+n-ah ( ) O # Kea%aan +m+m # ;am'a6 $a6!- Ke$a%aran # Com'o$ men-!$ ;an%a *!-al#

;e6anan %arah # /33?43 mmH"& Na%! # 8B=?men!-Re$'!ra$! # 12 =?men!- S+h+ a%an# 14&/ oC






He'ar # 1 1 @m a@ & L!en# -!%a6 -era a E=-rem!-a$ # A6ral han"a-& CR; 0T&A # POS; DHF "r. III

P #




27/44

FOLLO UPPe%a*a!an Ha%i Ke.; 4 = desem,e% 67389 S # Demam ( )& 6a6! -an"an %!n"!n ( )& m+n-ah ( ) O # Kea%aan +m+m # ;am'a6 $a6!- Ke$a%aran # Com'o$ men-!$ ;an%a *!-al#

;e6anan %arah # /33?43 mmH"& Na%! # 8B=?men!-Re$'!ra$! # 12 =?men!- S+h+ a%an# 14&/ oC







P #




28/44

FOLLO UPPe%a*a!an Ha%i Ke.< 4 > desem,e% 67389 S # Demam ( )& 6a6! -an"an %!n"!n ( )& m+n-ah ( ) O # Kea%aan +m+m # ;am'a6 $a6!- Ke$a%aran # Com'o$ men-!$ ;an%a *!-al#

;e6anan %arah # /33?B3 mmH"& Na%! #>8=?men!-Re$'!ra$! # 1B=?men!- S+h+ a%an # 1B&B oC

Ke'ala?SSP # '+'!l +la- !$o6or 1mm 1mm& RC ?&RF ? & RP ? & $'a$-!6 ( )&!6-er+$ ( ). Kon9+n"-!*aanem!$ ( )& $6lera !6-er!6 ( )& PCH ( )& ! !r $!ano$!$( )





P #

O0 / 0 L?m (6?') IVFD RL 8 "--?men!- ($-o')IVFD RL 8 "--?men!- S-o'

Ce =!me 0 = /33 m" Oral!- a% l! !-+m

Pro # rawa- 9alanHasil La,o%a!o%ium :

H # /0&> m"?%LH- # 15&2 7Le+6o$!- # 5.333?mm1

;rom o$!-# 80.333?mm1Er!-ro$!-# 2&58?mm1


29/44

Pem,a asan Den"+e $'e6-r+m 6l!n!$ yan" $an"a-

l+a$& $er!n" -an'a -er%+"a'er6em an"an 6l!n!6 %an ha$!la6h!rnya. Ke-!6a anya6 'a$!en$em +h %en"an $en%!r!nya -an'amen!m +l6an 6l!n!6 yan" era-&

$e a"!an 6e@!l 'o'+la$! er6em an"men9a%! 'enya6!- era-& $elal+%en"an 6ara6-er!$-!6 6eh!lan"an

'la$ma %en"an a-a+ -an'a


30/44

Pem aha$an

Kr!-er!a HO# 'a$!en memen+h! 0 %ar! 2 DHF Demam men%a%a6 0 4 har! %!$er-a! "e9ala

'er%arahan %en"an a-a+ -an'a $yo6W

(%emam B har!& -orn!:+e- )- He'a-ome"al! ( )- La ora-or!+m men+n9+6an -om o$!-o'en!a

( /33.333) (22.333?mm)- Pen!n"6a-an hema-o6r!- 037 a-a+ le !h&

%ar! har"a normal (287).


31/44

Pem aha$an

S!n%rom $yo6 Den"+e a%alah 6eem'a-"e9ala D D %!-am ah %en"an man!,e$-a$!6e"a"alan $!r6+la$!& ya!-+# na%! @e'a-& %an

lemah %en"an 'enyem'!-an -e6anan na%!( 03 mmH") a-a+ 'en+r+nan -e6anan%arah %an a6ral %!n"!n $er-a -am'a6"el!$ah.(6el+han 6a6! %an -an"an %!n"!n $e9a6 /2

9am SMRS& Na%!# /03 ?men!- re"+ler& -!%a66+a- an"6a-)


32/44

Pem aha$an Pa$!en men"alam! 'en+r+nan $+h+ a%an

$aa- ma$+6 r+mah $a6!- ya!-+ 1B&4 %era9a-@el@!+$ %!$er-a! -an%a -an%a 6e"a"alan$!r6+la$! ya!-+ a6ral %!n"!n %an lem a .

Pada #e&us!a#aan: mema$+6! ,a$e6r!-!$ 6e-!6a $+h+ -+r+n 6e 14&5 18 C a-a+ 6+ran"&!a$anya 'a%a har! 6e 1 4 %ar! $a6!-& %an'en!n"6a-an 'ermea el!-a$ 6a'!ler yan" %!!6+-!%en"an 'en!n"6a-an hema-o6r!- m+n"6!n -er9a%!. In!mer+'a6an -an%a %!m+la!nya ,a$e 6r!-!$. Per!o%e6l!n!$ %ar! plasma leakage !a$anya $elama 02 28


33/44

Pem aha$an

DL# le+6o$!-2.433?mm1&

H /4&/3m"?%L H- 2/&3 7

- -rom o$!-o'en!a22.333?mm

Pada #e&us!a#aan:la ora-or!+mhemo6on$en-ra$! yan"!$a %!l!ha- $e@ara 6l!n!$

%an la ora-or!+m(hema-o6r!- 037). Dan-rom o$!-o'en!a(-rom o$!- /33.333?mm 1).'en!n"6a-an 6a%ar Hmer+'a6an +6-!-er9a%!nya 6e o@oran

la$ma. Le+6o en!a


34/44

Pem aha$an Hal !n! mer+'a6an 6r!-er!a

la ora-or!+m %ar! DHF. Sela!n !-+-an%a 6e"a"alan $!r6+la$! $e'er-!na%! yan" lemah& a6ral %!n"!n %anlem a . Hal !n! men+n9+6an ahwa'a$!en !n! men"alam! DHF %era9a- III


35/44

Pem aha$anKe&us!a#aan: - Nyer! %! %aerah 'er+-& 'a%a

%aerah e'!"a$-!6& %an a-a$6o$-a 6anan. $aa- $e el+m

$yo6 -!m +l.- Per%arahan "a$-ro!n-e$-!nal

%an a-a+ he'a-ome"al!.- Selama 6on%!$! $yo6 a-a+ 're

$yo6& 'a$o6an %arah 6e or"an*!$@eral -elah er6+ran"menye a 6an h!'o6$!a

9ar!n"an %!!6+-! oleh nyer!

'er+-.

Nyer! 'er+-


36/44

Pem aha$an Ke&us!a#aan : ;an%a ahaya la!n $e el+m

$yo6 a%alah m+n-ah yan" -er+$ mener+$&a6+m+la$! @a!ran %! ro""a !n-er$-!$!al&'er%arahan m+6o$a& lethargy & "el!$ah&he'a-ome"al! 0 @m.

Me$6!'+n +6+ran %ar! ha-! -!%a6 er6orela$!

%en"an 6e'arahan 'enya6!-& -e-a'!'em e$aran ha-! ham'!r $elal+ a%a 'a%a'a$!en $yo6 %! an%!n"6an 'a$!en -!%a6 $yo6


37/44

Pem aha$anD!a"no$!$ an%!n"#Syo6 $e'-!6 ya!-+ $e'$!$ era- %en"an %!$,+n"$! or"an@ar%!o*a$6+ler #/. H!'o-en$! # ;e6anan %arah 5 'er@en-!l er%a$ar6an

+m+r me$6!'+n X23 ml?6" @a!ran %alam $a-+ 9am.0. Mem +-+h6an o a- *a$oa6-!, +n-+6 men9a"a

-e6anan %arah.1. De $!- -an'a $e a 5 mE:?L& La@-a- ar-er! 0 6al!

normal& D!+re$!$ 3&5 ml?6" ?9am& 'en"!$!an6a'!ler 5 %e-!6& %an 'er e%aan -em'era-+re '+$a-%en"an 'er!,er 1 C.)


38/44


39/44

Pem aha$an

DSS S!"n! 6an le !h 6e@!l6em+n"6!nannya +n-+6 men"alam!re$'on $!n%rom !n ama$! $!$-em!6&

$e'er-! -a6!6ar%!& %an mem!l!6! -e6ananna%! lemah $aa- ma$+6 !la%! an%!n"6an %en"an 'a$!en SSS-a-+$ men-al le !h m+%ah %!'er-ahan6an& %an

'er%arahan 6l!n!$ $'on-an le !h $er!n" -er9a%! 'a%aana6 ana6 %en"an DSS %! an%!n"6an ! SS.

M+n"6!n !n! ha$!l %ar! 6on%!$! yan" %!%om!na$!*a$o%!la-a$! %! SS %! an%!n"6an 6ea%aan

*a$o6on$-r!6$! yan" mer+'a6an re$'on awal DSS


40/44

Pem aha$anPa%a 'a$!en !n! -era'! DHF "ra%e III- IVFD 6r!$-alo!% ya!-+ R!n"er La6-a- 03 @@ ?6" 223 @@

(06al!) %en"an -e-e$an @e'a- $elama /5 men!-&- ;e6anan %arah -!%a6 na!6& 'em er!an 6olo!% ("elo,+$!n) /3

@@?6" $e anya6 003 @@ $elama /5 men!-.- Se-elah -er9a%! 'er a!6an 6ea%aan& @a!ran %!"an-! 6e R!n"er

la6-a- -er+$ %!-+r+n6an er-aha' /3@@?6" ?9am ya!-+003@@ o $er*a$! $elama 1 9am&

- ;e6anan %arah $-a !l -+r+n6an men9a%! 4@@?6" ?9am /52 @@ $elama 2 9am& 5@@?6" ?9am //3 @@ $elama 8 9am%an -era6h!r 1@@?6" ?9am BB @@ $elama /5 9am.

- Se a"a! -era'! $+'or-!,& In9e6$! an-! !o-!6 @e,o-a=!me 1=453m" IV. Ana6 %!an9+r6an +n-+6 m!n+m anya6 lar+-anele6-rol!- (oral!-)& -!rah ar!n"& %an 'em er!an an-!'!re-!6'ara@e-amol 1= / -a le- 9!6a $+h+ a%an men!n"6a-.


41/44

Pem aha$an Ke&us!a#aan # 'em er!an an-! !o-!6 'a%a

'en%er!-a DHF -!%a6 %!'erl+6an. Ke'+$-a6aan la!n# an-! !o-!6 $ehar+$nya

%! er!6an 'a%a 'a$!en DHF& +n-+66em+n"6!nan a%a !n,e6$! a6-er!. Pana$ yan"lama ( 5 har!) %an a%anya Acute renalFailure -elah %!la'or6an $e a"a! ,a6-or re$!6o!n%e'en%en +n-+6 a%anya !n,e6$! a6-er! 'a%a'a$!en %ewa$a. A%anya $a6!- 'er+- 9+"amer+'a6an -an%a %ar! !n,e6$! a6-er! a6-!,'a%a 'a$!en DHF

P h $


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Pem aha$an

Ke&us!a#aan # Pro"no$!$ 'a%a DHF a%alah %+ !a

6arena %!-en-+6an oleh e era'a ,a6-or $e'er-!# Lama %an era-nya ren9a-an& wa6-+& me-o%e&

$er-a a%e6+a- -!%a6nya 'enan"anan& %!l!ha- %ar!-e6anan %arah& -e6anan na%! %an %!+re$!$.

A%a -!%a6nya re6+ren $yo6 yan" -er+-ama -er9a%!%alam B 9am 'er-ama $e-elah 'em er!an @a!ran'aren-eral %!m+la!.

A%anya %emam $elama ren9a-an erlan"$+n"&

men+n9+6an 'ro"no$a le !h +r+6. A%a -!%a6nya -an%a -an%a 'en+r+nan ,+n"$!

$ere ral& %!mana men"arah6an 'em!6!ran 6!-a'a%a -er9a%!nya en$e,alo'a-!.


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Pem aha$anPo"no$!$ a% @i!am du,ia ad ,onam #

Pa$!en 6el+ar %ar! ,a$e $yo6 %en"an 6ea%aan -an%a*!-al yan" a!6& 'a$!en ere$'on -erha%a' 'em er!an@a!ran !n-ra*ena& -e6anan %arah $!$-ol!6 ra-a ra-a X >3

mmH"& -e6anan na%! X 13 mmH"& $er-a 'a%a 'a$!enra-a ra-a MAP X83 mmH" $elama -era'! -!%a6h!'o-en$!.

- D!+re$!$ 'a$!en ra-a ra-a X 0 ml?6"?9am& !n! men+n9+6an'er,+$! ora"an *!-al "!n9al a!6& $eh!n""a %a'a-%!$!m'+l6an 'a$!en -!%a6 men"alam! ren9a-an $yo6.

- ;!%a6 %emam $elama -era'! $yo6& -!%a6 a%a 'en+r+nan6e$a%aran.


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Pem aha$an P%o$nosis unB!ionam ad ,onam+

'a$!en %a'a- mela6+6an 6e"!a-anma6an& m!n+m %an a6-!*!-a$ $e'er-!!a$a.

P%o$nosis sana!ionam ad ,onam: 6arena 'a$!en $em +h -an'a a%a

6e@a@a-an.

Laporan Kasus Panjang Dengue Syok Sindrom

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