!SE B!SE" "IS#SSION MENINGITIS OLEH : Novianti 1115200 PEMBIMBING : dr. dr. Sylvia Sylvi a T, Sp.S
!nato$i M%nin&%n 'arin&an i(at yan& $%$)*n&(*+ ota( dan $%d*lla +pinali+ T%rdiri T%rdiri dari:
"*ra$at%r !ra-noid Pia$at%r
on&&a +*)ara-noid di antara ara-noid dan pia$at%r )%ri+i LS
LS di)%nt*( ol%- pl%(+*+ -oroid%*+ v%ntri(%l lat%ral LS nor$al:
/arna '%rniS%l 05$$ T%(anan 30200 $$H2O G*la 450 $&6 Prot%in 1545 $&6
MENINGITIS In7a$a+i pada $%$)ran ara-noid, pia$%t%r dan S8 9%r%)ro+pinal 8l*id Pro+%+ in7a$a+i $%l*a+ di +%l*r*- r*an& +*)ara-noid +%(itar ota( dan )atan& ota( dan $%li)at(an )%r)a&ai v%ntri(%l
M%nin&iti+ Ba(t%riali+ In;%(+i a(*t p*r*l%n dala$ r*an& +*)ara-noid. Hal ini t%r(ait d%n&an SSP r%a(+i in7a$a+i yan& dapat $%n&a(i)at(an (%+adaran $%n*r*n, (%'an&, p%nin&(atan intra(ranial 9IP, dan +tro(%.
M%nin&iti+ +%ro+a
LS '%rni-
P%ny%)a) : M.t*)%r*lo+i+, vir*+ 9Mumpsvirus, Echovirus, dan Coxsackie vir*+, to>opla+$a &ond-ii, ri(%t+ia
M%nin&iti+ p*r*l%nta
LS (%r*-
P%ny%)a) : "iploo*+ pn%*$onia, N%i++%ria $%nin&itidi+ , Str%ptoo*+ -a%$olyti*+, Stap-yloo*+ a*r%*+, H. in7*%n?a%, E. oli,
Etiolo&i @20 t- S.pn%*$onia 220 t N.$%nin&itidi+ N%onat*+, Aanita -a$il, pa+i%n i$*noo$pro$i+%d L.$onoyto&%n%+
P!TOGENESIS HEM!TOGEN M!S#< MELE/!TI S!L#!N PEN!P!S!N SE!! INT!<!NI!L MEL!L#I EN#L! "I N!SO8!ING IN8E
M%n%$p%l di +%l %pit%l $*(o+a M%n%$)*+ $*(o+a $a+*( (% +ir(*la+i
Ma+*( (% S8 l%Aat pl%>*+ -oroid v%ntri(%l lat%rali+ dan $%nin&%n
B%r+ir(*la+i (% %>tra+%r%)ral S8 C r*an& +*)ara-noid
Ba(t%ri )%r%pli(a+i (ar%na (on+%ntra+i anti)odi (o$pl%$%n yan& inad%(*at
Pato=+iolo&i
TI!S MENINGITIS
MENINGITIS T#BE<#LOSIS
Stadi*$ prodro$al
Stadi*$ p%ran&+an&an $%nin&%n
Stadi*$ (%r*+a(an ota( +%t%$pat
8%)ri+, $alai+%, ny%ri )adan, $yal&ia, +a(it (%pala, $*al, $*nta-, p%n*r*nan na;+* $a(an, dapat t%r'adi (%'an&
H%$ipara+%
Stadi*$ (%r*+a(an ota( di;*+%
P%n*r*nan (%+adaran
"ia&no+i+ Bandin& M. Purulenta
M. TBC
M. viral
<%r*-
B%nin&
B%nin&
M%nin&(at
S%di(it $%nin&(at
Nor$al
<%(%r*-an
<%r*-
%rni-
%rni-
S%di$%n
D
B%(*an
B%+ar dan (a+ar
%n&&an& -al*+
L%*(o+it 9$$ 100010.000 9n%*tro=l
F500 9li$;o+it
"o$inan PMN +%lan'*tnya MN
Eritro+it
02
010
0
F40 90
F50
450
Makroskopis /arna T%(anan
Mikroskopis
Kimia Gl*(o+a 9&dL
P%$)%rian o)at TB : ;a+% int%n+i; 4 o)at dii(*ti 2 o)at ;a+% lan'*tan 92HEHES5H, )ila TB $%ra&*(an )%ri(an %;tria>on% 2 > 2 &r
8i>%d "o+% O!T Setiap hari (Intensif) RHZ (!"#$%"$&##$'%")
$min**u (lan+utan) (!"#$!"#)
03
2 ta)l%t
2 ta)l%t
54
ta)l%t
ta)l%t
5530
4 ta)l%t
4 ta)l%t
@31
5 ta)l%t
5 ta)l%t
Intensif
,an+utan
i;a$piin
5 $& (&BB
10 $& (&BB
INH
10 $& (&BB
10 $& (&BB
Pira?ina$id
25 $& (&BB
5 $& (&BB
Et-a$)*tol
15 $& (&BB
15 $& (&BB
Str%pto$iin
15 $& (&BB
0 $& (&BB
RH
M%nin&iti+ iral In7a$a+i (roni+ yan& $%n&%nai $%nin&%n tanpa in;%(+i )a(t%rial pio&%ni(
G%'ala (lini( Sa(it (%pala 9)ia+anya )a&ian ;rontalr%troor)ital "%$a$ Tandatanda irita+i $%nin&%al P-otop-o)ia Sa(it (%ti(a $%n&&%ra((an )ola $ata N*-al ri&idity G%'ala (on+tit*tional : $alai+%, $ial&ia, anor%>ia, na*+% , vo$itin&, a)do$inal pain dan ata* diar%
M%nin&iti+ !+%pti(
Pro+%+ in;%(+i non viral Pro+%+ nonin;%(+i*+ -roni $%nin&itid%+ %*rr%nt $%nin&iti+ Eo+inop-ili $%nin&iti+
SSTEMI L#P#S ETHEM!TOS#S P%nya(it a*toi$*n $*lti+i+t%$i( $%r*pa(an -a+il dari +i+t%$ i$*n yan& di$%dia+i ol%- (%r*+a(an 'arin&an Mani;%+ta+i : (*lit, +%ndi, &in'al, +i+t%$ +ara; p*+at, +i+t%$ (ardiova+(*lar, $%$)ran +%ro+a, -%$atolo&i( dan +i+t%$ i$*n
P!TO8ISIOLOGI !*toanti)odi r%a(+i +ilan& d%n&an +%l n%*ron r%+%ptor p%r$*(aan &l*ta$at dan "N! yan& $%$%dia+i +%l n%*ron yan& $ati dan )%r(ontri)*+i t%r-adap di+;*n&+i (o&niti; !nti)odi )%ri(atan lan&+*n& d%n&an ri)o+o$ prot%in P n%*rop+y-iatri !nti)odi anti;o+;olipid )%r(ontri)*+i d%n&an prooa&*lant +tat%, va+*lar tro$)o+i+ dan i+(%$i( +%r%)ral M%diator in7a$a+i IL, I8Nα, matrix
metaloproteinase
manifestasi neuropsychiatric
P%$%ri(+aan p%n*n'an& iAayat +%)%l*$nya La)oratori*$ %>a$ination+ !nali+i+ S8 p%nin&(atan (adar prot%in, r%nda- &l*(o+a MI d%t%(+i a)nor$alita+ intraranial
PEN!T!L!
