Professional Documents
Culture Documents
1
1
1
1 Dengue 1 virus
Neutralizing antibody to Dengue 1 virus
Non-neutralizing antibody
1 Complex formed by neutralizing antibody and virus
Heterologous Antibodies
Form Infectious Complexes
2
2 2
2
2
Dengue 2 virus
2
2
2
2
2
2 2
2
2
2 Dengue 2 virus
Non-neutralizing antibody
Virus Previously
replication antibody
Virus-antibody complex respons
Endothelial Complement
Platelet agregation
disturbances activation
Complex virus-antibody
Complemen activation
Complemen
or somnolence)
Dengue virus infections
10,000
Asymptomatic Symptomatic
9,000 1,000
Plasma leakage
50DF, 50 DHF
Non-shock Shock
DHF DSS
(Dengue shock syndrome)
48 1-2
Systolic + Diastolic
2
= 5
Fever Shock
Pleural effusion,
Ascites
Hari sakit/demam
Time of fever defervescence
Demam Berdarah Dengue
Tips
Pada DBD setelah suhu turun:
Klinis memburuk, lemah, gelisah,
tangan kaki dingin, nafas cepat,
diuresis berkurang,
tidak ada nafsu makan
Hari sakit
Monitor H-1 H-2 H-3 H-4 H-5 H-6 H-7 H-8 H-9 H-10
Tek darah
Nadi
Frek nafas
Suhu
Kesadaran
Pemantauan berkala selama
Jantung perawatan
Paru
Hati
Diuresis
Balans cairan
Hb
Cairan
Foto toraks
Diuresis
Transfusi darah
Returning Home Criteria for the Patient
Epidemiology : -
Age groups : Pre school age children
Heart :
Myocardial fibers are degenerated and the heart
is dilated
Conduction disturbance
CNS : polyneuritis
Delirium
Culture
Laryngeal diphtheria :
Croup
Acute epiglottitis
Laryngotracheobronchitis
Peritonsillar abscess
Retropharyngeal abscess
Cont .
Faucial diphtheria :
Acute streptococcal membranous tonsillitis
( high grade fever , child less toxic )
Management of complication
Antitoxin
Diphtheria antitoxin :
Pharyngeal or laryngeal diphtheria of 48 hours
duration : 20,000 to 40,000 units.
Nasopharyngeal lesions : 40,000 60,000 units
Extensive disease of 3 or more days duration or
patient with swelling of neck : 80,000 120,000
units
Antitoxin may be repeated if the clinical
improvementis slower
Antibiotics
Penicillin :
Procaine penicilline ( 3 6 lac units IM at 12
hourly intervals till the patient is able to swallow )
Oral penicillin ( 125 250 mg qid )
Myocarditis :
Fluids and salt restriction
Sedation and oxygen supply
Diuretics and digoxin
Neurological complications :
Palatal paralysis ( NG feeding )
Generalised weakness ( as polio )
Prognosis
Death may occur due to : -
Respiratory obstruction
Myocarditis
Respiratory paralysis
MEASL
ES
Measles
Highly contagious viral illness
First described in 7th century
Near universal infection of childhood in
prevaccination era
Common and often fatal in developing
areas
Paramyxovirus (RNA)
Rapidly inactivated by heat and light
Measles Pathogenesis
Respiratory transmission of virus
Replication in nasopharynx and regional
lymph nodes
Primary viremia 2-3 days after exposure
Secondary viremia 5-7 days after
exposure with spread to tissues
Measles Clinical Features
Incubation period 10-12 days
Prodrome
Stepwise increase in fever to
103F or higher
Cough, coryza, conjunctivitis
Koplik spots
Measles Clinical Features
Rash
2-4 days after prodrome, 14 days after
exposure
Maculopapular, becomes confluent
Begins on face and head
Persists 5-6 days
Fades in order of appearance
Measles Complications
Diarrhea
Otitis media
Pneumonia
Encephalitis
Hospitalization
Death