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TRANSCRIPT
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By : Dina Israni Putri
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Diphtheria
Corynebacterium diphtheriae
acute infectious disease
spreads easily
attacked mainly the upper respiratory tract
a typical pseudomembranous formation
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Corynebacterium diphtheriaeGram-positive,aerobic,nonmotile,rod-shaped bacteria. characteristic of forming irregular shaped, club-shaped or V-shapedChinese letters.
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Airborne respiratory
droplets
Exudates from infected skin
lesions
Direct contact with
respiratory secretions
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Clinical SymptomsThe incubation period : 2-6 daysUsually the disease slightly veiled attacks, such as :
- mild sore throat-heat is not high, ranging between 37.8 º C - 38.9 º C. -Initially only throat hiperemis but most have occurred membranes white / grayish.
Within 24 hours of the membrane can spread and cover the tonsils, palate Molle, uvula.
At - first, a thin membranewhite and webbed becomes thick gray / black difficult to be lifted
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According to its severity, the disease is divided into 3 levels• Mild infections
pseudomembran only found in the nasal mucosa with only symptoms of painful swallowing
• Moderate Infection -pseudomembran have attacked until the pharynx-swelling of the larynx
• Severe infection-severe respiratory obstruction -with complication (myocarditis , paralysis and Nefritis)
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Nasal diphtheria- Cold- Secretions that come out mixed a little blood from pseudomembranous
Pharyngeal and Tonsillar Diphtheria- Acute Sore throat- Pseudomembranous extend to the nasopharynx and larynx- Breath odor- bullneck
Larygeal anf Tracheal Diphtheria- Hoarseness and stridor- dispnea, cyanosis and looked suprasternal and epigastrium retraction - bull neck
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ImmunizationDPTType : - DTwP (whole pertusis)
- DTaP ( accellular pertusis)Dossage : 0,5 mg IM or subcutan
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DosePrimary 1Primary 2Primary 3Primary 4
Age2 months4 months6 months15-18 months
Interval ---4 wks4 wks6 mos
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DTaP, DT
Td, Tdap (adult)
Diphtheria7-8 Lf units
2-2.5 Lf units
Tetanus5-12.5 Lf units
5 Lf units
DTaP and pediatric DT used through age 6 years. Adult Td for persons 7 years and older. Tdap for persons 10 through 64 years or 11 through 64 years
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Routine DTaP Schedule for Children Younger Than 7 Years of Age
4 through 6 years of age, before entering school
11 or 12 years of age if 5 years since last dose (Tdap)
Every 10 years thereafter (Td)
Booster Doses
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Dose*Primary 1Primary 2Primary 3
Interval ---4 wks6 to 12 mos
Booster dose every 10 years
*For children 10 years of age and older ACIP recommends that one of these doses (preferably the first) be administered as Tdap
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TreatmentNon spesific Spesificcomplete bed rest, isolation of patients soft foods are easily
digested, contains enough protein and calories
Antibiotic- Penicilin procain- Eritromicin- Linkomicin
ADSCorticosteroid
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Type Doses
Nasal Diphtheria 20.000 Intramuskular
Tonsingeal Diphtheria 40.000 Intramuskular/intravena
Faringeal Diphtheria 40.000 Intramuskular/intravena
Laringeal Diphtheria 40.000 Intramuskular/intravena
Combination 80.000 Intravena
Diphtheria+ complication, Bull Neck 80.000-120.000 Intravena
Late treatment (>72 h), in anywhere 80.000-120.000 Intravena
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Prognosis1. Age of patients
2. Antitoxin treatment time
3. Type of clinical diphtheria
4. Patient's general condition
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Thank You