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TYPHOID FEVER
A CASE PRESENTATION
PEDIATRIC STATION OF WALEDHOSPITAL
MEDICAL FACULTY OF UNSWAGATI
CIREBON2015
CONSULTANT:Irman Permana Dr! S"!A!
CREATED ANDPRESENTED BY:
Noviana Estikasari.
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Patients Identity:
Name :An. R.Age :10 years old
Sex : Male
Address : Karang Mekar
Marriage Stats :Single
Religion :Islam!ate Entering "os#ital :$%to&er '(t)*'01+
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ANAMNESIS
C#$e% C&m"'a$n : ,)e #atient #resented -it) ever
H$()&r* &% Pre(en) I''ne(( :A male /)ild -as &rog)t &y )er #arents to t)e emergen%y%are nit o aled Regen%y "os#ital -it) ever* #er%eiveda&ot seven days ago. ,)e ever elt sin%e Satrday atert)e #atient %ame &a%k rom s%)ool $%to&er 12t)* '01+3.
,)e ever s4ered -as 5%tating 6 arise es#e%ially in t)ening)t and de%reases in t)e morning.
,)e Patient also %om#lained o diarr)oea* or a&ot ( times#er day. ,)e stool -as loose and -atery* -it)ot m%osand &lood. 7eside t)at* t)e #atient also %om#lained onasea and &ody -eakness.
,)e #atient -as &rog)t &y )er #arents to a nearest
#rimary )ealt) %are a%ility* &t t)e sym#toms arentim#rove -it) t)e treatment.
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Pa() Me+$,a' H$()&r*,)e Patient -as never s4er rom same
%om#lain &eore
Fam$'* H$()&r*None o t)e amily mem&er )as t)e same %om#laint
or )as ever &een )os#itali8ed or t)e same%om#laint 93
S&,$a' an+ E,&n&m* H$()&r*
,)e Patient rarely eat t)e meal %ooked &y )ermot)er and #reer to %onsme n)ealty sna%ksater s%)ool.
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H$()&r* &% M&)#er-( Pre.nan,* an+C#$'+/$r)#
,)e #atients mot)er: rotine %)e%k#s int)e village mid-ie "istory o illness dring #regnan%y 93 ,)e Mot)er denied any %onsm#tion o ot)er
medi%ine &t t)e s##lemental medi%ationrom t)e %)e%k#s
Per$na)a' an+ P&() na)a':
,)e #atient -as &orn s#ontaneosly* termgestational age* and t)e delivery -as )el#ed&y a mid-ie.
,)e #atient -as s#ontaneosly %ry at &irt)
H$()&r* &% M&)#er-( Pre.nan,* an+C#$'+/$r)#
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eeding "istory
0 6 ; mont)s : 7reastmilk
2 mont)s : Milk Porridge< Mont)s : ,im Ri%e
= Mont)s : Porridge
1' Mont)s : Solid ood
Immunization
"e#atitis :>x
7/? :1xPolio :(x
!P, :>x
Measless @a%%ine :1x
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H$()&r* &% Gr&)# an+ Dee'&"men)
A.e Gr&)# an+ Dee'&"men)
( mont)s A&le to lying on )er stoma%)
< mont)s A&le to sit do-n
1 year old A&le to -alk
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P#*($,a' Eam$na)$&n
Genera' Eam$na)$&n:
Genera' A""earan,e: Moderately ill
C&n(,$&3(ne(( Lee': ll %ons%iosness E( @+M;3
4$)a' S$.n:
Hear) Ra)e : 1>'xminte
RR :'( xminte
Tem" : >=*1o/
An)#r&"&me)r*:BW: '; kg
67F$n+$n.(
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L&,a' Eam$na)$&n
Hea+
E*e( : /onBn%tival Pallor 99S%leral I%ters 99
Ne,8
Dym#)adeno#at)y 99
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T#&ra
In("e,)$&n
Normot)orax* symmetri%al* &ro-n skin*inter%ostal retra%tion 93* a#ex &eat is nseen
Pa'"a)$&n
,enderness 93* Normal a#ex &eat or%e*
symmetri%al ta%til remits.Per%ssion : Sonor on t)e -)ole o t)e lngeld
As%ltation : 7@S FF* )ee8e 993. R)on%)i993* Symmetri%al @o%al remits
C#&r+$( :
1stG 'nd"eart sond are reglar* no mrmr* no
gallo#.
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A&domen* Extremities and Skin
A/+&men :
7ro-n skin* Sot* distention 93* E#igastri%retra%tions 93 Normal &o-el sonds E#igastri% tenderess Diver and s#leen is not #al#a&le Skin trgor reverse ra#idlyE)rem$)$e( :arm A%ro%yanosis 99 /a#illary rell time H'v Preti&ial edema 993
6 6
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Re(3me:
A 10 years old male %)ild -as &rog)t to
Emergen%y /are Jnit o aled "os#ital -it) ever*#er%eived 2 days ago. ,)e ever ty#e -as remitten.Nasea and &ody -eakness are also #resent."e -as &rog)t to t)e rst )ealt %are a%ility &t
t)e sym#toms doesnt im#rove -it) t)e treatment.,)ese are t)e ndings rom #)ysi%al examination.,)e general a##earan%e -as moderately ill* t)elevel o %ons%iosness ll level o %ons%iosness
E(@+M;3."R: 1>' RR: '( ,em#: >=*1o/. 7: '; kgrom t)e a&dominal examination* e#igastri%tenderness -as ond.
E9AM!
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D$eren)$a' D$a.n&($(
!enge ever
,y#)oid ever
R&3)$ne B'&&+ Te() 4a'3e
Haem&.'&/$n =**1
Er*)#r&,*)e (*'
Hema)&,r$) '=
P'a)e'e) 1;'0S. Paraty#)i A9$ L 1: >'0S. Paraty#)i 79$ L 1:>'0
S. Paraty#)i /9$ L 1: 1;0S. ty#)i " L 1:>'0S. Paraty#)i A9" L 1:1;0S. Paraty#)i 79" L 1:>'0S. Paraty#)i /9" L 1:00
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T#era"*:
I@! RD > %%Kg 7ody eig)t)or
Para%etamol (x>00 mg iv
/etriaxon 'x1 gr iv
!iet %ontains liid ood* < x 1+0 %%
Pr&.n&($( :
9 o ad @itam : Ad &onam
9 o ad n%tionam : Ad &onam
9 o ad Sanationam : Ad &onam
E+3,a)$&n
7ed Rest dring ever
Diid diet dring illness
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Man* T#an8(