Teaching Bangsal

8/11/2019 Teaching Bangsal

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TEACHING BANGSAL

HERPES ZOSTER

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Group Nameo MUHAMMAD ADIYATH S.o NUR ULUL AMRANo A. TENRI SYAHIRAH S.o ARMIN ABAS S.o EVY MISELVY T.o FIRGHANA ATTAMIMIo MULIANA KHAERUNIZAH N.o MUHAMMAD IQBAL T.o ANDI MUHAMMAD LATE R.o ANDI DIRHAN TAKDIRo MUHAMMAD AKAHRIHWAN A. GALIGO

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PATIENT IDENTITY

Name : Ampa DG NgaiGender : MaleAge : 53 y.oAddress : Rannaya GowaMarital Status : MarriedReligion : MoeslemAdmission Date : 1st August 1961Medical Record Number : 679677

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History Taking

Anamnesis : AutoanamnesisChief complaint : Watery pimples scars

Further Anamnesis : Patient complain about itchy and

burn on the left chest that spread to the left back that hefeels 5 days ago. After a few days appear reddish spotthen appear spots that filled with transparent liquid,spot that filled with liquid is appear that accumulatedon the one area and can crush if it scratched, Fever (+)Malaise (+), Anorexia (+)Latest disease : varicella (+) 3 years ago

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History Taking

Treatment history : (-) Family History with the same complaint : (-)

History of allergy : (-) Medical history : (-)

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Physical Examination

Anemic (+), icterus (-), cyanose(-) Cor/Pulmonal : S1 S2 normal, reguler, Rh -/-

Wh -/- Abdomen : Normal, peristaltic (+) Extremities : Edema (-)

Lymph nodes : Enlargement (-)

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Current Status Consciousness : Concious (E4V5M6) General Condition : Severe Hygiene : Medium

Vital Sign BP : 100/60 mmHg

PR : 92 x/minutes RR : 20x/minutes T : 38,4 C

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DERMATOLOGY STATUS

Location : Regio Thoracalis Anterior et Posterior

Efflorescence : vesicles, eruption, crust

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BEFORE TREATMENT

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AFTER TREATMENT

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Laboratory Result RBC : 3,4. 10 6 /uL WBC : 16,05 10 3 uL HGB : 9,3 g/dL HCT : 28,0 % PLT : 318. 10 3 /mm 3 GDS : 128 mg/dl Ureum : 24 mg/dl

Creatinin : 0,60 mg/dl SGOT : 42 U/I SGPT : 33 U/I

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Diagnosis

Herpes zoster

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Treatment

R/ IVFD NaCl 0,9% 28dpmAcyclovir 5x 400 mg

Neurodex 2x1Cetirizine 10 mg 1x1 (if itchy)Mefenamat Acid 3x500mg (if pain)

MBO Talk (morning-afternoon)

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Dermatology status :Location : Regio Thoracalis Anterior et Posterior

SinistraEfflorescence : Vesicles, Eruption, Crust

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Discussion

Herpes zoster : Segmental (dermatomal) painful skin

disease caused by reaction of VZV

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Epidemiology

1.5 3.0 per 1,000 person-years in allages and 7 11 per 1,000 per year in personsover 60 years of age in European and NorthAmerican studies.

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Clinical Manifestation

1. Dysesthesias or pain in distribution of theaffected nerve without visible skin changes.Typically burning or lancinating pain

2. Eruption of grouped vesicles and thenpustules on an erythematous base

3. Healing with drying, crusting, and usuallysome scarring (7 days)

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Clinical Diagnosis

Varicella can usually be diagnosed readily onthe basis of the appearance and evolution ofits characteristic rash particularly when thereis a history of exposure within the preceding2 3 weeks

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Complication

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Treatment

Antiviral therapy :- Acyclovir 5 x 800 mg/day (7 days)

- Valacyclovir 3 x 1000 mg/day- Famciclovir 3x500 mg/day (7 days)

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Prevention

Vaccination

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REFERENCE Straus S, Oxman M, Schmader K. Varicella and herpes Zoster.

Wollf K, Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, LeffelDJ. In Fitzpatricks Dermatology In General Medicine. 7thEdition. McGraw-Hill; New York 2008

Handoko R. Penyakit Virus.Djuanda A, Hamzah M, Aisah S.Dalam Ilmu Penyakit kulit dan Kelamin. Edisi ke 5. Jakarta:Balai Pustaka FKUI;2009

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Thank You

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Teaching Bangsal

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