Download - Pneumonia (4)
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PNEUMONIA
DEFINISI
Peradangan dan pemadatan jaringan
paru yang disebabkan oleh bahaninfeksius
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KLASIFIKASI
Community Acquired Pneumonia (CAP)- Pneumonia yang diproleh dari luar
rumah sakit Hospital Acquired pneumonia - Pneumonia yg timbul 7 jam atau lebih
setelah dira!at di rumah sakit "nstitution acquired pneumonia - Pneumonia karena tindakan pera!atan
di #$% di rumah dll&
PNEMONIA
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'ersering emam
*enggigil
Pleuritic chest pain (pleuropneumonia)
+atuk
$esak nafas $putum non produktif% produktif% rusty%
berdarah% berbau pada abses paru
MANIFESTASI KLINIK
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',P"CA .ejala klinik seperti diatas
isebabkan oleh Pneumococcus%
staphylococcus% H "n/uen0ae A',P"CA .eja penyakittidak khas
+atuk 1on produktif2 mukoid
isebabkan oleh egionella% mycoplasma%Chlamydia
Campuran antara typical and atypical
MANIFESTASI KLINIK
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*A1"34$'A$" 151 #4$P"#A'5# 1yeri kepala
*ual *untah 1yeri Abdomen iare
1yeri otot 2 *yalgia 1yeri sendi 2 arthralgia
Pasen tua lebih banyak keluhan dpyang muda
MANIFESTASI KLINIK
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$uhu
- emam- Hypothermia- Afebris pd 6 kasus
'hora8
"1$P49$" - hemithora8 yg sakit tertinggal PAPA$"
- :ocal fremitus meningkat P4#9;$"
- sonor memendek 2 dull A;$9;'A$"
- sub bronkial 2 bronkial
- ronki basah sedang nyaring
- pleural friction rub
PEMERIKSAAN FISIK
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P4*AA'A1P 35'5 '5#A9$2 "nfeksi
Perdarahan Cairan edema
9eganasan
"n/amasi penyebab lain
(
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P
NEUMO
NIA
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;4 '5 'he Cause can not be determined from the
clinical presentation Complete microbiological studies can
isolate
only = >6 of causati:e pathogen andtake
long enough time (? @ hours)
Pathogen isolated from sputum cannot besure
as the causati:e agent $5
4tiologic diagnosis of pneumoniacate ori0ed as
ETIOLOGIC DIAGNOSIS
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A*"$$"512#434# 4C"$"51
"mportant step after diagnosis has been made"ndication
#isk factors for a complicated course or *ortality inPatients !ith CAP
Age ? > yearsCo-morbid illnesses that are likely to be made !orse
by the pneumonia% especially chronic renal failure%
ischemic heart disease% congesti:e heart failure% andse:ere C5P
Concurrent malignancyPostsplenectomy stateAltered mental status
Alcoholism"mmunosuppresi:e therapy#espiratory rate ? D6 breaths per minuteiastolic blood pressure = 6 mm Hg systolic blood
pressure = E6 mmHg
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Hypothermia
Creatinine ? F>6 mm2l or +;1 ? 7 mm2l
eukopenia = D%6662ul or leucocytosis ? D6%6662ul5 = 6 mmHg or Pco ? @ mmHg !hile breathing room air
Albumin = D6 gm2l
Hemoglobin = E gm2l
Pseudomonas aeruginosa or $taphylococcus aureus as the cause of thePneumonia
+acteremic pneumonia
*ultilobe in:ol:ement on chest radiograph
#apid radiographic progression of the pneumonia deBned as increase inthe si0e of the pulmonary opacity of ? >6 !ithin D h
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5;' PA'"41'$ Chest G ray Complete leucoyte count 4lectrolyte
Creatinin 58ygen saturation $putum culture and gram stain
"1 PA'"41'$As abo:e$putum culture and gram stain+lood culture (t!ice)
DIAGNOSTIC WORK UP
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$P;';* C;';#4 A1 .#A* $'A"1
#4P#4$41'A'"
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$4#55., 35# PA'H5.41 *& Pneumoniae C& Pneumoniae Co8iella +ornetti egionella Pneumophilla Adeno:irus
"n/uen0a2Parain/uen0a #$