Demam Tifoid

Question 1

Etio Demam Tifoid

Answer 1

Salmonella typhii

Question 2

Transmisi Demam Tifoid

Answer 2

Fecal oral → makanan

Question 3

Klinis Demam Tifoid

Answer 3

• Demam >7 hari (step ladder) → sore-malam demam makin naik
  Minggu 1: remiten
  Minggu 2: kontinu
• Typhoid tongue (tengah kotor, tepi hiperemis, tremor)
• Bradikardi relatif (↑ 1°C ≠ ↑ 10x/m)
• Gangguan GI (diare, konstipasi)
• Rose spot → ruam kemerahan di tubuh

Question 4

PP Awal Demam Tifoid

Answer 4

• Widal test (+): Titer O ≥1/320 atau meningkat 4x lipat
• Tubex (+)
  + ≥4
  + 6 → sangat kuat

Question 5

Gold Standard Demam Tifoid

Answer 5

• Kultur
  Darah → minggu 1
  Feses → minggu 2
  Urin → minggu 3
  ATAU sumsum tulang → minggu 1
  ATAU empedu → minggu berapa pun

Question 6

Tx Non Farmako Demam Tifoid

Answer 6

Bedrest, diet lunak TKTP, rendah serat

Bakteri → ileus distal (Peyer’s patch) → usus terganggu

Question 7

Tx Farmako Demam Tifoid: Dewasa

Answer 7

1. Kloramfenikol 4x500 mg (7-14 hari)
2. Ciproloxacin 2x500 mg (7-14 hari)
3. Ceftriaxone 2-4 g/hari (5 hari)
4. Cefixime 2x600 mg (7-14 hari)

Ko Ci Cef2

Question 8

Tx Farmako Demam Tifoid: Ibu Hamil

Answer 8

Kloramfenikol → ES: anemia

Ciprofloxacin, cotrimoxazole, streptomycin → Embriotoksik

Amoksisilin ATAU Cephalosporins (Ceftriaxone, Cefixime, Cefotaxim) → Aman bumil (bukan hanya di demam tifoid)

Question 9

Tx Farmako Demam Tifoid: Anak

Answer 9

1. Kloramfenikol 25-50 mg/kgBB/hari 10-14 hari → ES: Depresi sutul
2. Amoksisilin 100 mg/kgBB/hari 10 hari
3. Cotrimoxazole 6 mg/kgBB/hari 10 hari

K A Co

Question 10

Komplikasi Demam Tifoid

Answer 10

1. Perforasi usus → peritonitis
2. Tifoid toksik → penkes