Batuk Dengan Atau Tanpa Sesak Nafas: DR Ari Kurniasih M, Ked (Ped), Spa
Batuk Dengan Atau Tanpa Sesak Nafas: DR Ari Kurniasih M, Ked (Ped), Spa
ATAU TANPA
SESAK NAFAS
DR ARI KURNIASIH M,KED(PED), SpA
Pencetus batuk
Defenisi
Klasifikasi
Etiologi
Penyebab batuk kronik
berdasarkan usia
Batuk kronik
Magnitude of the Problem
in Indonesia
Anatomical classification
Lobar pneumonia
Lobular pneumonia
Intertitial pneumonia
Bronchopneumonia
Etiological classification
Bacterial pneumonia
Viral pneumonia
Mycoplasma pneumonia
Aspiration pneumonia
Mycotic pneumonia
Etiology of Pneumonia
Streptococcus pneumoniae
Hemophilus influenzae
Staphylococcus aureus
Streptococcus group A – B
Klebsiella pneumoniae
Pseudomonas aeruginosa
Chlamydia spp
Mycoplasma pneumoniae
BACTERIA ISOLATED FROM LUNG ASPIRATES
IN 370 UNTREATED CHILDREN WITH PNEUMONIA
%
50
40
30
20
10
0
S Pneumoniae H Influenzae S Aureus
Characteristic features
S pneumoniae
mucosal inflammation lesion
alveolar exudates
frequently lobar pneumonia)
H influenzae, S viridans, Virus
invasion and destruction of mucous membrane
Staphylococcus, Klebsiella
destruction of tissues multiple abscesses
Simple Clinical Signs of Pneumonia (WHO)
Respiratory thresholds
Age Breaths/minute
< 2 months 60
2 - 12 months 50
1 - 5 years 40
Chest Indrawing
(subcostal retraction)
Female girl, 6,5 y cxr interstitial infiltrates, ec S pneumoniae: IgG
pneumolysin increased Leucocytosis 29800, ESR 35 mm/h I, CRP 9 mg/l.
Male boy, 1,9 y, cxr alveolar infiltrates in right lobe ec. S pneumoniae: IgG
pneumolysin increased, leucocytosi 13.800, ESR 125/h I, CRP 332 mg/l.
Female girl, 2,8 y, cxr alveolar infiltrates in lower left lobe ec. rhinovirus:
leucocytosis 17700, ESR 64 mm/h I, CRP 128 mg/l.
Female infant, 0,3 y, cxr. alveolar infiltrates in upper right lobe ec parainfluenza and
human herpes virus, leucocytois 17000, ESR 8 mm/ h l, CRP 22 mg/l
Management
Severe Pneumonia
Hospitalization
Antibiotic administration
Procain Pennicilline, Chloramphenicol
Amoxycillin + Clavulanic Acid
Intra Venous Fluid Drip
Oxygen
Detection and management of complications
WHO recommendations for treatment of infants less 2
months who have cough or difficulty breathing
Outpatients
Age Inpatients (Moderate) Inpatients (Severe)
(Mild to Moderate)
Amoxicillin with or
Ceftriaxone or cefotaxime
3 - 6 mos without clavulanate Ceftriaxone or cefotaxim
+ vancomycin
Erythromycin