Lecture 5 INFECTION IN PEDIATRIC
1. DENGUE HEMORRHAGIC FEVER References :
TatalaksanaDemam DengueDemamBerdarah Dengue Krugman’s Infectious Diseaseof Children
Nelson text book of Pediatrics
Abstract Dengue hemorrhagic Fever DHF is a viral infection disease caused by dengue
viral DEN 1, DEN 2, Den 3 and DEN 4 with the symptom that are : fever 2 to 7 days, bleeding manifestation, enlargement of liver and shock with laboratory
criteria thrombocytopenia and haemoconcentration. Four grade DHF from WHO are : grade I; fever with no specific symptom Rumple Leed RL +, grade II; grade
I + spontaneous bleeding, grade III; manifestation of circulatory failure and grade IV; profound shock.
Management DHF according of the grading of disease as well as suspicion DHF, DHF grade I, II and Dengue Shock Syndrome.
Learning Task
3 years old boys came with chief complaint high fever no decrease from three days ago, no cough and without sore throat. According to his parent he had vomited, no
appetite no drink.
Task :
1. What are other helpful information you trying to get from his parent ? 2. What the physical examine you need to this patient ?
3. When the Rumple Leedepositive, what the kind of the laboratory test you
have done ? 4. If the laboratory test showed leucopenic and trombositopenic, how about the
management to this patient ?
Self Assessment:
1. What the clinical spectrum of dengue infection? Explain it 2. How about the patophysiology of Dengue Hemorrhagic Fever ?
3. Explain the pathogenesis of shock in DHF 4. How the bleeding occur in DHF ?
5. Explain DHF clinicallyaccording the WHOcriteria 6. Explain the DHF complication
7. How about the management of DHF? Explain it 8. Mention the hospitalization of DHF patient the indication of hospitalization
9. Indication of discharged from hospital.
Udayana University Faculty of Medicine, DME, 2017
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2. DIPHTHERIA References :
Krugman’s Infectious Diseaseof Chlidren Nelson text book of Pediatrics
Nelson Essentials of Pediatrics
Abstract Diphtheria is a preventable acute disease caused by Corynebacterium Diphtheria.
Diphtheria is acquired by contact with ill person with the disease or with an asymptomatic carrier of organism. The incidence increase among school age
children during the first few month of the school year has been reported. Diphtheria usually develops after a short incubation period of 2 days with a range of 1 to 5
days. For clinical purposes, the disease my be classified by the anatomic location as a nasal diphtheria, tonsilar and pharyngeal diphtheria, laryngeal diphtheria,
cutaneus diphtheria and unusual type of diphtheria. The diagnosis of diphtheria is confirmed by the demonstration of diphtheria bacilli cultured from material obtained
from the site of infection. Diphtheria antitoxin must be given promptly and in adequate dosage. Penicillin and erythromycin are effective against most strains of
diphtheria bacilli. Supportive therapy is needed for several cases and complication.
Preventive therapy by immunization with diphtheria toxoid.
Self Assessment
1. Explain the etiology of diphtheria 2. How the pathogenesis of diphtheria ?
3. Mention the sign and symptom that we could find in patient suffered from
diphtheria based on the location of the infection 4. Explain how to diagnosis diphtheria
5. Mention the differential diagnosis of diphtheria based on the anatomic site of involvement
6. Explain some severe complication caused by the effect of diphtheria toxin 7. Explain the management of diphtheria
3. TETANUS References :
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