PEMERIKSAAN TUBEX •
Diagnosis Demam Tifoid dengan Pemeriksaan TUBEX.
autor: PRAMITA Lab, Lab, 9. júla 2009, 1:30 DIAGNOSIS DEMAM TIOID.
D!"a" T#$o#% T#$o#% "!ru&a'a( &!()a'#t !(%!"#' %!(*a( +ala +atu ta(%a 'l#(#+()a a%ala D#ar!. Suatu !&#%!"#' %!"a" t#$o#% )a(* "ult#%ru* r!+#+ta(t %a( ta(&a +uatu &!(*obata( )a(* a%!'uat, 10 - &!(%!r#ta()a "!(#(**al ol! &!()a'#t t!r+!but. P!()!bab uta"a %a( &al#(* ba()a' a%ala Sal"o(!lla t)&# atau Sal"o(!lla !(t!r#a +ub+&, E(t!r#a +!rot)&! t)&#.
/ARA AR DETESI DEMAM TIOID
!r%a+ar'a( &r#(+#& %!t!'+# a(t#bo%# I*M +&!+#$#' Sal"o(!lla t)&# %ala" +!ru" %!(*a( ara I(#b#t#o( Ma*(!t# #(%#(* I""u(oa++a) IMI 4 "!(**u(a'a( 56Sa&! 56Sa&! R!at#o( 7! 7!ll+, ll+, TE8 T "!"b!r#'a( alt!r(at#$ +olu+# %!t!'+# %#(# D!"a" T#$o#% '!&a%a 'l#(#+# t!ruta"a "!(*a%a&# "a+ala '!!&ata(, '!a(%ala( %a( '!()a"a(a( %#a*(o+#+.
DEENISI DAN PRINSIP TE8
TE8 T a%ala +u+tu t!+t %#a*(o+t# #(#tro +!"# 'ua(t#tat#$ 10 "!(#t u(tu' %!t!'+# D!"a" T#$o#% a'ut )a(* %#+!bab'a( ol! Sal"o(!lla t)&#, "!lalu# %!t!'+# +&!+#$#' a%a()a +!ru" a(t#bo%# I* M t!r+!but %ala" "!(*a"bat #(#b#+# 4 r!a'+# a(tara a(t#*!( b!rlab!l &art#'!l lat! "a*(!t# r!a*!( ;ar(a o'lat 4 %a( "o(o'lo(al a(t#bo%# b!rlab!l lat! ;ar(a r!a*!( ;ar(a b#ru 4, +!la(jut()a #'ata( #(#b#+# t!r+!but %# +&ara+#'a( +&ara+#'a( ol! +uatu %a)a "a*(!t#. T#(*'at #(#b#+# )a(* %#a+#l'a( a%ala +!tara %!(*a( 'o(+!(tra+# a(t#bo%# I* M S. t)&# %ala" +a"&!l.
(ot!?#%@1090BC1B2 •
EVALUASI EVALUASI PEMERIKSAAN TYPUS MEN!!UNAKAN TUBEX
Ala"%ul#lla, +!t!la "!(**u(a'a( T"#e$ T +!ba*a# &!"!r#'+aa( D!"a" T#$o#% t)&u+4 +!ja' a'#r S!&t!"b!r 200C )a(* lalu %# Ra;at I(a& Palara( Sa"ar#(%a4, 'a"# "!()!l!+a#'a( &a'!t a;al t!r+!but %a( "!(oba "!"buat r!'a&#tula+# +!ba*a# baa( !alua+# taa& &!rta"a. Ma+# +a(*at "!(ta, "u(*'#( t#%a' a%a a&a&u( )a(* %a&at %#&!t#' %ar#()a, (a"u( 'a"# b!rara& a%a()a "a+u'a( %ar# b!rba*a# &#a' u(tu' &!"a'a#a( Tub! taa& b!r#'ut()a. Saat "!lu(ur'a( &o+t#(* Tub!, a%a b!b!ra&a "a+u'a( %#a(tara()a +ara( &!(t#(* %ar# Mas Ri%a& %o't!r!ar!'#l#' %ot ;or%&r!++ %ot o"4 t!(ta(* &!rlu()a bata+a( "!(**u(a'a( EM4
+!ba*a# &!(%u'u(* u(tu' baa( 'aj#a(. Na"u( 'ar!(a b!rba*a# '!(%ala, +ara( b!l#au b!lu" b#+a 'a"# la'+a(a'a(. (tu' taa& b!r#'ut()a, (#+a)a 'a"# a'a( "!la'u'a(()a. S!la#( #tu, ata+ "a+u'a( "ba' S'in(a, 'a"# ju*a t#%a' "!"bata+# &!(**u(aa( Tub! u(tu' ;ar*a "#+'#( +!"ata, "!la#('a( u(tu' +!"ua &!(%!r#ta )a(* %#ur#*a# "!(%!r#ta D!"a" T)&o#% +!t!la %!"a" ar# '! . Pu( %!"#'#a( u(tu' *olo(*a( u"ur, &!"!r#'+aa( Tub! b!rla'u u(tu' +!"ua u"ur t!r"a+u' a(a'6a(a' +!+ua# +ara( Mas Ri%a&. !r#'ut #(# a%ala R!'a&#tula+#: P!(**u(aa( Tub! T %# Pu+'!+"a+ Ra;at I(a& Palara(, ota Sa"ar#(%a. S!&t!"b!r 200C6a(uar# 200
No
Nama
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Ke(erangan
01
N). Su(
2B T
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0C r
R.I(a& Pal
02
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0 r
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0 r
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12 r
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KETERAN!AN*
1. u"la Pa+#!( %#&!r#'+a: 2 ora(* &a+#!( 2. u"la o(trol &!"!r#'+aa(: 2 &!"!r#'+aa( 3. Pa+#!( %#ra;at %# Ra;at I(a& Palara(: 13 &a+#!( B. R!!ral &a+#!( %#ruju'4: B ora(* &a+#!( .
1. Pasien no. ,- &a%a ar# %#'o(+ul'a( '! %r a(a' %# RSD Sa"ar#(%a, %#b!r#'a( &!(*obata( +!+ua# &roto'ol &!(atala'+a(aa( T#$o#%, (a"u( %ala" &!r'!"ba(*a(()a %#ruju' '! %r a(a' %# &ra't!' %!(*a( %u*aa( !aga& !ina& Ak"( , %a( ol! %r a(a' %#+!tuju# %#a*(o+a Ga*al G#(jal A'ut. S!la(jut()a &a+#!( %#ra;at %!(*a( &roto'ol Ga*al G#(jal A'ut %a( %#()ata'a( +!"bu &a%a ar# '! 1C .
2. Pasien no. ,/ a%ala &#(%aa( %ar# RSD T!(**aro(* %!(*a( &!"!r#'+aa( 7#%al N!*at#$ 64, %a( &!"!r#'+aa( la#(, t!r"a+u' Malar#a N!*at#$, (a"u( &a(a+ t#%a' 'u(ju(* turu( +!#(**a &!(%!r#ta &#(%a '! R. I(a& Palara( ru"a()a %# Palara(4 %a( t!r()ata &a%a &!"!r#'+aa( Tub! "!(u(ju''a( &o+#t#$ . S!la(jut()a &!(%!r#ta %#ra;at +!+ua# tatala'+a(a &!ra;ata( T#$o#%. o(trol &a%a ar# '! 1 +!t!la "!(jala(# Ra;at ala(, &!"!r#'+aa( Tub! "!(u(ju''a( &o+#t#$ 2 %!(*a( 'o(%#+# 'l#(#+ ta(&a '!lua(. 3. Pasien no. 01, +!b!lu"()a %#ra;at %# RS S;a+ta %!(*a( a+#l &!"!r#'+aa( Laborator#u" t#%a' "!(u(ju''a( '!la#(a(. Pa%a ar# '! 1 %!"a", '!luar*a &a+#!( t#(**al %# Palara(4 "#(ta %#la'u'a( &!"!r#'+aa( Tub! %# Ra;at I(a& P alara( %a( "!(u(ju''a( a+#l &o+#t#$ 10 "a'+#"al &o+#t#$ 124. S!la(jut()a &a+#!( "!(jala(#
D!"#'#a( a+#l +!"!(tara P!(**u(aa( T#b! +!ba*a# &!(u(ja(* %#a*(o+a &a+#!( %!(*a( %u*aa( D!"a" T#$o#%. tt&:==a'"o'#.;or%&r!++.o"=200=01=2=!alua+#6tub!6taa&61= •
Pemeriksaan Demam Tifoid Terkini
D#t!rb#t'a( S!&t!"b!r 23, 200C Art#'!l , lo* ,
2e&3ome* Pemeriksaan Terkini Demam Tifoid
S!bua &!rjala(a( &a(ja(* "!(uju a'ura+# P!"!r#'+aa( &!(u(ja(* D!"a" T#$o#% "!(ua# a+#l. !(%at# b!lu" +!+ua# ara&a( ba()a' &#a', +!bua #(oa+# t!la la#r %!(*a( a+#l u'u& "!"ua+'a(. !ta&a t#%a', '!+ul#ta( "!(!ta&'a( %#a*(o+a &a+t# D!"a" T#$o#% )a(* +!la"a #(# +ul#t t!rl!b# %# %a!ra &!r#$!r or &#(**#ra(4 t!rja;ab +u%a. !lu" b#+a "!rata "!"a(*, (a"u( +!t#%a'()a +u%a b#+a "ula# "!(*!(t#'a( &ro 'o(tra %#a*(o+a b#a+ t!(ta(* K !ea&a Tif"s . P!(ul#+ +a(*at t!rla"bat +!'#tar 3 tau( +!ja' %#lu(ur'a(4 "!(ul#+ r!#!; &ro%u' #(#, )a'(# +!bua t!robo+a( &!+at &!"!r#'+aa( t!r'#(# D!"a" T#$o#%. 7!lo"!: TE8 T. Pro%u' #(# &!rta"a %#&ubl#'a+#'a( &!rta"a tau( 19B, '!"u%#a( %#lu(ur'a( +!ara 'o"!r+#al tau( 200B. <#(**a '#(# b!lu" ba()a' la)a(a( '!+!ata( RS4 )a(* "!(**u(a'a( &ro%u' #(#. T!"a(6t!"a( %o't!r +&!+#al#+ P!()a'#t Dala" %# Suraba)a t#%a' ba()a' "!"b!r#'a( #($or"a+# t!(ta(* &!"a'a#a( Tub! T. a'a( %#'ata'a( ba;a Tub! T b!lu" %#ja%#'a( &!"!r#'+aa( +ta(%ar %ala" &!(u(ja(* &!(!*a'a( %#a*(o+a D!"a" T#$o#%. D# Sa"ar#(%a +!(%#r#, a()a +!bua RS S;a+ta )a(* "!(**u(a'a(()a. 7ajar, "!(*#(*at ar*a()a )a(* u'u& "aal %a( a%a '!"u(*'#(a( &ara %o't!r "a+# b!r+#'a& ;a#t a(% +!!. a"#, &!la'+a(a &!(*a%aa( obat %a( baa( ab#+ &a'a# o&!ra+#4 Pu+'!+"a+ Ra;at I(a& Palara(, Sa"ar#(%a "!"b!ra(#'a( %#r# "!(**u(a'a(()a +!t!la "!"&!lajar# +!la"a 'ura(* l!b# bula(. E" "o b!r*a)a %oa(* or aro*a( > ol!la %#a(**a& b!*#tu, (a"u( 'a"# +u%a "!"&!rt#"ba(*'a(()a "a+a'6"a+a', la*#&ula 'a"# t#%a' !(**u(a'a( %a(a (!*ara.
S!'al# la*# #(# %#'!lola ol! o&!ra+# )a(* '!b!tula( &!(ul#+ +!ba*a# &!(a+!at()a4 +!t!la "!lalu# b#(a(* la"a %!(*a( &ara a(**ota )a(* ju*a &ara"!%#+ &!la'+a(a ar#a( &!ra;ata(. A&a t#%a' "!"b!rat'a( &!(%!r#ta > <"""&!rta()aa( )a(* ;ajar %a( #(#&ula +ala +atu &!rt#"ba(*a( 'a"#. )a #)ala, 'a( "!r!'a %#b#a)a# ol! (!*ara, +o *a' &!rlu (*!luar#( %u;#t +!(%#r# b!tul *a' > !!!. To+++. So, Tub! T )a(* "!(**u(a'a( "!to%! I(#b#t#o( Ma*(!t# #(%#(* I""u(oa++a) MI4 #(# r!+"# %#*u(a'a( +!t!la r!#!; +#(*'at '!&a%a &ara a;a' Pu+'!+"a+ Ra;at I(a& Palara(, Sa"ar#(%a &a%a ar# M#(**u, 23 S!&t!"b!r 200C. Sa+ara(: &!(%!r#ta 7ar*a M#+'#( Ga'#(4 %!(*a( %u*aa( 'l#(#+ D!"a" T#$o#% &a%a ar# '!l#"a %!"a". M!to%!: %#+'r#&t#$ aa' t!rbata+ 30 &!(%!r#ta. 7a'tu: 23 S!&t!"b!r 200C623 S!&t!"b!r 200. #a)a: +;a'!lola.
S!*ala +!+uatu t!r'a#t latar b!la'a(*, *a"bara( +#(*'at D!"a" T#$o#% %a( +!%#'#t ura#a( ara '!rja Tub! T a'a( %#tul#+ %ala" +!r#al +!la(jut()a.
!(%at# "!"a'a# (a"a %a**a(* Tub! t$4, (a"u( 'a"# t#%a' t!r#'at %!(*a( &#a' "a(a&u(. tt&:==a'"o'#.;or%&r!++.o"=200C=09=23=&!"!r#'+aa(6%!"a"6t#$o#%6t!r'#(#= •
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Demam T45'oid dan Diagnosis La#ora(ori"m 6In7i(ro Diagnos(ik8
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A5aka' Pen4aki( Tif"s i(" 9
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S!la(* ;a'tu a(tara #($!'+# %a( &!r"ulaa( +a'#t "a+a #('uba+#4 b!r*a(tu(* %ar# ba()a'()a ba't!r# )a(* "a+u' '! tubu. Ma+a #('uba+# b!r'#+ar a(tara 61B ar#.
A5a Saa !ea&a Pen4aki( Tif"s 9
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A5a Yang ar"s Di&ak"kan :ika Menem"kan !ea&a Pen4aki( Tif"s 9
#'a t!r%a&at *!jala &!()a'#t t#$u+, +!*!rala la'u'a( &!"!r#'+aa( laborator#u" u(tu' "!(!*a''a( %#a*(o+#+ &!()a'#t t#$u+. !t!rla"bata( %#a*(o+#+ %a&at "!()!bab'a( 'o"&l#'a+# )a(* b!ra'#bat &a%a '!"at#a(.
Pemeriksaan La#ora(ori"m A5a Saaka' Yang Da5a( Di&ak"kan 9
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Pemeriksan A5aka' Yang Da5a( Diadikan A&(erna(if Un("k Mende(eksi Pen4aki( Tif"s 9
P!"!r#'+aa( A(t# Salmonella typhi I*M %!(*a( r!a*!( Tub!T +!ba*a# +olu+# &!"!r#'+aa( )a(* +!(+#t#$, +&!+#$#' %a( &ra't#+ u(tu' "!(%!t!'+# &!()!bab %!"a" a'#bat #($!'+# ba't!r# Salmonella typhi.
A5aka' Yang Dimaks"d Pemeriksaan An(i Salmonella typhi IgM Dengan Reagen T"#e$;T< 9
P!"!r#'+aa( A(t# Salmonella typhi I*M %!(*a( r!a*!( Tub!T %#la'u'a( u(tu' "!(%!t!'+#
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A5aka' Ke&e#i'an Pemeriksaan An(i Salmonella typhi IgM Dengan Reagen T"#e$;T< 9
6
D!t!'+# #($!'+# a'ut l!b# %#(# %a( +!(+#t#$, 'ar!(a a(t#bo%# I*M "u(ul &al#(* a;al )a#tu +!t!la 36B ar# t!rja%#()a %!"a" +!(+#t##ta+ 9-4.
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