Background: Syphilis is one of the most common sexually transmitted infections every year. In mothers who do not receive treatment, transmission of infection from mother to fetus can occur, causing congenital syphilis. The purpose of this study was to describe the characteristics of cases of congenital syphilis in Wangaya Hospital, Denpasar. Methods: This descriptive study used the medical records of pediatric patients at the Wangaya Hospital, Denpasar, for the period January 2020 to October 2021. The inclusion criteria used were newborns diagnosed with congenital syphilis with complete medical record data. The exclusion criteria used were newborns suffering from congenital syphilis accompanied by other infections, namely Toxoplasma gondii, rubella, cytomegalovirus, herpes simplex, and other congenital disorders not related to syphilis. Results: Of the 47 study subjects who met the inclusion criteria, 68.1% of cases were asymptomatic and 31.9% symptomatic, 68.1% of term pregnancy, 31.9% preterm, low birth weight 29.8%, very low 4 .3%, and 66% normal body weight. Clinical manifestations found in symptomatic cases were respiratory distress (27.7%), jaundice/jaundice (21.3%), anemia (19.1%), skin lesions/rash (12.8%), sepsis (10 .6%), leukocytosis (10.6%), and thrombocytopenia (10.6%). Outcome of survival was 93.6% and death was 6.4% of cases. Conclusion: Most cases of congenital syphilis are asymptomatic. In symptomatic cases, the characteristic clinical manifestations that are often encountered are respiratory distress, jaundice, anemia, skin rash, sepsis, leukocytosis, and thrombocytopenia. Recognizing the characteristics of congenital syphilis cases early is very important to reduce mortality from the disease. Latar Belakang: Sifilis merupakan salah satu infeksi menular seksual yang banyak terjadi setiap tahunnya. Pada ibu yang tidak mendapatkan pengobatan, dapat terjadi transmisi infeksi ibu ke janin sehingga menyebabkan kejadian sifilis kongenital. Tujuan penelitian ini adalah untuk mengetahui gambaran karakteristik dari kasus-kasus sifilis kongenital di RSUD Wangaya kota Denpasar. Metode: Penelitian deskriptif ini menggunakan rekam medis pasien anak di RSUD Wangaya kota Denpasar periode Januari 2020 hingga Oktober 2021. Kriteria inklusi yang digunakan adalah bayi baru lahir yang didiagnosis sifilis kongenital dengan data rekam medis yang lengkap. Kriteria eksklusi yang digunakan adalah bayi baru lahir yang menderita sifilis kongenital disertai infeksi lainnya, yaitu Toxoplasma gondii, rubella, cytomegalovirus, herpes simplex, maupun kelainan kongenital lain yang tidak berkaitan dengan sifilis. Hasil : Dari 47 subjek penelitian yang masuk di dalam kriteria inklusi, 68,1% kasus asimptomatik dan 31,9% simptomatik, kehamilan aterm 68,1%, kurang bulan 31,9%, berat badan lahir rendah 29,8%, sangat rendah 4,3%, dan berat badan normal 66%. Manifestasi klinis yang ditemukan pada kasus simptomatik, yaitu distres nafas (27,7%), ikterus/jaundice (21,3%), anemia (19,1%), lesi/ruam kulit (12,8%), sepsis (10,6%), leukositosis (10,6%), dan trombositopenia (10,6%). Luaran hidup 93,6% dan meninggal 6,4% kasus. Kesimpulan : Sebagian besar kasus sifilis kongenital tidak bergejala atau asimptomatik. Pada kasus bergejala, karakteristik manifestasi klinis yang sering ditemui adalah distres nafas, jaundice, anemia, ruam kulit, sepsis, leukositosis, dan trombositopenia. Mengenali karakteristik kasus sifilis kongenital sejak dini sangat penting untuk mengurangi mortalitas dari penyakit.
Background: Congenital syphilis is an infectious disease of newborns caused by Treponema pallidum, a spirochete bacterium, from vertical transmission from infected mother to fetus. Diagnosis of congenital syphilis can be difficult because two-thirds of affected infants are asymptomatic at birth, and the signs of symptomatic infants are diverse. Familiarity with the various presentations is essential to early diagnosis and treatment.Case Description: A male preterm, 35 weeks gestation baby, born by vaginal delivery from G1P0 mother with syphilis latent phase, with Treponema pallidum hemagglutination assay (TPHA) titer reactive (1:2560) with no treatment during the antenatal period. The baby was born with low birth weight, respiratory distress syndrome, hepatosplenomegaly, and skin rash. Diffuse desquamation and fissures also multiple eroded pale blisters are known as pemphigus syphilitics. TPHA was also reactive at the same level as the mother. Complete blood count showed severe respiratory acidosis (pH: 6,8), leucocytosis (46.420/uL), thrombocytosis (414.000/uL), lymphocytosis (40,3%), and monocytosis (16%). Radiology showed severe atelectatic left lung and course nodular congenital pneumonia of the right lung. The baby was intubated and injected with penicillin procaine 50.000 IU/kg/day intramuscularly in the neonatal intensive care unit (NICU). However, due to severe atelectatic lung and acidosis, this case resulted in a fatal outcome.Conclusion: Broad desquamation, multiple fissures, and eroded pale blisters (vesiculobullous lesions) known as pemphigus syphilitics should alert clinicians as an early manifestation of congenital syphilis. Other manifestations include congenital pneumonia, typically atelectatic or nodular type, and hepatosplenomegaly. Treatment should be started promptly to decrease its morbidity and mortality.
Background: DHF is a health problem in Indonesia because the morbidity and mortality rates are high, so a practical examination is needed to assess the progression of DHF to reduce its morbidity and mortality. MPV is a simple laboratory test that has not been widely studied in DHF. This study aims to determine the relationship between the MPV and the clinical degree of DHF. Method: The study was conducted with a cross-sectional design on pediatric patients aged 0 – < 18 years with DHF and treated in June 2020 – August 2021 at Wangaya General Hospital, Denpasar, Bali. DHF diagnosis was based on WHO 2011 criteria, divided into groups of DHF and DSS. The normal reference MPV is 7,5-11,5fl, and values >11,5 fl are considered high. Data were analyzed by SPSS 25. Result: Eighty patients participated in the study, 56 DHF patients and 24 DSS patients. High MPV values >11.5 fl were found more in the DSS patient group (54,16%) than the DHF group (30,35%) (OR: 3,5; 95% CI: 1,29-9,68; p = 0,023). There was a moderate negative correlation between MPV and platelet count values (r: -0,438; p < 0,05). Conclusion: MPV value has a relationship with the clinical degree of DHF. High MPV values (> 11,5 fl) have a 3,5 times risk higher for the occurrence of DSS compared to patients with normal MPV values (7,5-11,5 fl). The degree of thrombocytopenia in dengue is inversely proportional to the MPV value. Latar belakang: Demam berdarah dengue (DBD) merupakan masalah kesehatan di Indonesia karena angka kesakitan dan kematiannya yang cukup tinggi, sehingga diperlukan pemeriksaan praktis yang dapat digunakan dalam menilai progresivitas DBD agar dapat mengurangi morbiditas dan mortalitas dari penyakit ini. Mean platelet volume (MPV) adalah pemeriksaan laboratorium sederhana yang yang belum banyak diteliti perannya pada DBD. Penelitian ini bertujuan untuk mengetahui hubungan antara nilai MPV dengan derajat klinis DBD. Metode: Penelitian dilakukan dengan desain potong lintang tehadap pasien anak usia 0 – <18 tahun dengan DBD dan dirawat pada bulan Juni 2020 – Agustus 2021 di RSUD Wangaya Kota Denpasar. Diagnosis DBD berdasarkan kriteria WHO 2011, dibagi menjadi kelompok DBD tanpa syok dan sindrom syok dengue (SSD). Acuan nilai normal MPV 7,5-11,5 fl dan nilai >11,5 fl dianggap tinggi. Analisa menggunakan SPSS versi 25. Hasil: Didapatkan 80 pasien mengikuti penelitian, 56 pasien DBD tanpa syok dan 24 pasien SSD. Nilai MPV tinggi >11,5 fl didapatkan lebih banyak pada kelompok pasien SSD (54,16%) dibandingkan kelompok DBD tanpa syok (30,35%) (OR: 3,5; 95% IK: 1,29-9,68; p= 0,023). Didapatkan hubungan korelasi negatif berkekuatan sedang antara nilai MPV dan trombosit (r: -0,438; p< 0,05). Kesimpulan: Nilai MPV memiliki hubungan dengan derajat klinis DBD. Nilai MPV tinggi (>11,5 fl) memiliki risiko 3,5 kali untuk terjadinya SSD dibandingkan pasien dengan nilai MPV normal (7,5-11,5 fl). Derajat trombositopenia pada dengue berbanding terbalik dengan nilai MPV, semakin berat derajat trombositopenia semakin tinggi nilai MPV.
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