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AMOEBA KELAS RHIZOPODA PROTOZOA BERGERAK DG PSEUDOPOD I ( KAKI SEMU ). PATOGEN: 1. ENTAMOEBA HISTOLYTICA, 2. MENINGOENCEPHALITIS AMOEBA ( FREE-LIVING AMOEBA) TIDAK PATOGEN : 1. ENTAMOEBA COLI 2. E. GINGIVALIS 3. ENDOLIMAX NANA 4. IODAMOEBA BUTSCHLII 5. DIENTAMOEBA FRAGILIS.
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AMOEBA KELAS RHIZOPODAPROTOZOA BERGERAK DG PSEUDOPODI (KAKI SEMU) • PATOGEN: 1. ENTAMOEBA HISTOLYTICA, 2. MENINGOENCEPHALITIS AMOEBA (FREE-LIVING AMOEBA) • TIDAK PATOGEN: 1. ENTAMOEBA COLI 2. E. GINGIVALIS 3. ENDOLIMAX NANA 4. IODAMOEBA BUTSCHLII 5. DIENTAMOEBA FRAGILIS
AMOEBIASISEpidemiology Prevalence : varies with level of sanitation • higher in tropics and subtropics than in temperate climates. • Entamoeba histolytica is the second leading cause of mortality due to parasitic disease in humans. (The first being malaria). • Worldwide prevalence is about 10% to 50% WITH 50.000-100.000 DEATH/YEAR • Cyst passers (CARRIER):important source of infection
TRANSMISSION • 1.DIRECT CONTACT of person to person ( FECAL-ORAL) • 2- VENEREAL TRANSMISSION among homosexual males( ORAL-ANAL ) • 3- FOOD & DRINK contaminated with feces containing the E.hist. cyst • 4- Use of human FECES fertilizer • 5- contamination of foodstuffs by FLIES, and possibly COCKROACHES
Clinical Symptoms • Asymptomatic infection/CARRIER • SYMPTOMATIC INFECTION AMOEBIASIS • INTESTINAL EXTRAINTESTINAL Amebiasis symptoms: Hepatic: Liver abscces Diarrhea or dysentery, Pulmonary Abdominal pain, The extra foci Cramping , Anorexia, COLITIS: Dysenteric Non-Dysenteric
AMOEBIASISDIAGNOSIS • CLINICAL SYMPTOM • MICROSCOPIC EXAMINATON • IMMUNODIAGNOSIS • RADIOLOGIC (X –RAY) EXAMINATION (EXTRA INTESTINAL)
IMMUNODIAGNOSIS 1- Antibody detection 2- Antigen detection may be useful as an adjunct to microscopic diagnosis 3- SEROLOGY(complement fixation test (CFT), indirect hemagglutination (IHA), Precipitin test) 4- Intradermal Test
TREATMENTAMOEBIASIS METRONIDAZOLEDRUG OF CHOICE INTESTINAL AMOEBIASIS ADULT, 3X750 MG/DAY FOR 10 DAYS CHILDREN. 3X15 MG/KG BW FOR 10 DAYS LIVER AMOEBIASIS: 1X1.5G-2.5G/DAY FOR 3 DAYS OTHER DRUGS: TINIDAZOLE, ORNIDAZOLE, NIMORAZOLE, SECNIDAZOLE
PREVENTION • FOOD/DRINKING WATER:COOKED WELL • PERSONAL HYGIENE • ENVIRONTMENTAL HYGIENE • VECTOR CONTROL:FLIES, COCKROACHES • LABORATORY WORKERS (PRIMATE FECES) • CARRIER : FIND &TREAT
FREE-LIVINGAMOEBA (a). ACANTHAMOEBA : WARM BRACKISH WATER (b). NAEGLERIA FOWLERI: WARM FRESH WATER TROPH: 14-40 MICRON CYST : 10-25 MICRON
CLINICAL INFECTION MENINGOENCEPHALITIS PHARYNGITIS, FEVER,HEADACHE MENINGITIS DEATH • EYES & SYSTEMIC INFECTION • SKIN INFECTION TREATMENT: AMPHOTERICIN B PREVENTION: WARM WATER RECREATION HYGIENE
CRYPTOSPORIDIUM PARVUM CRYPTOSPORIDIOSIS: CHOLERA-LIKE DIARRHEAE FEVER, NAUSEA, DEHYDRATION IN HIV/AIDS FATAL
EPIDEMIOLOGYLIFE CYCLE • COSMOPOLIT • ZOONOSIS. • CROWDED POPULATION • LOW HYGIENIC ,
PATOGENESIS & GEJALA KLINIK SPOROZOITKERUSAKAN&KERADANGAN EPITEL USUS D.P.T NORMAL: KLINIS RINGAN D.P.T RENDAH , GANGGUAN SISTEM IMUN (MISALNYA AIDS/HIV • DEMAM • DIARE CAIR (CHOLERA-LIKE DIARRHEA) • NYERI PERUT, MUAL • DEHIDRASI, BERAT BADAN MENURUN
PATOGENESIS & GEJALA KLINIK SPOROZOITKERUSAKAN&KERADANGAN EPITEL USUS D.P.T NORMAL: KLINIS RINGAN D.P.T RENDAH , GANGGUAN SISTEM IMUN (MISALNYA AIDS/HIV • DEMAM • DIARE CAIR (CHOLERA-LIKE DIARRHEA) • NYERI PERUT, MUAL • DEHIDRASI, BERAT BADAN MENURUN
OOKISTA CRYPTOSPORIDIUM PEWARNAAN TINJA DENGAN ACID-FAST KIYOUN MODIFICATION (diameter: 4- mikron) SPORULATED OOCYST
SEBARAN GEOGRAFIS Toxoplasma gondii: • KOSMOPOLIT, termasuk ZOONOSIS. • OBLIGAT INTRASELULER • 2 FASE SIKLUS HIDUP: • INTESTINAL (ENTEROEPITELIAL) • EXTRAINTESTINAL
SIKLUS HIDUP • FASE INTESTINAL (PADA KUCING) terbentuk OOKISTA (oocyst) • FASE EXTRAINTESTINAL (PADA HEWAN TERINFEKSI LAINNYA, TERMASUK KUCING DAN MANUSIA) • Terbentuk BRADIZOITdan TAKIZOIT
PENULARAN • PER ORAL ( OOKISTA –pada tinja kucing) 2. BRADIZOIT (pada DAGING MENTAH/TAK MATANG 3. PENULARAN TRANSPLASENTAL ABORSI SPONTAN, LAHIR MATI, BAYI LAHIR CACAT MENTAL/FISIK.
TOXOPLASMOSIS (MANUSIA) • UMUMNYA : ASIMTOMATIK • PADA IMUNITAS YG RENDAH(MISALNYA AIDS) BISA TERJADI: TOXOPLASMOSIS BERAT, DG HEPATITIS, PNEUMONIA, BUTA, GANGGUAN SARAF.
GEJALA KLINIK • Sebagian besar toksoplasmosis asimtomatik. • Imunokompeten: flu like symptom, limfadenopati • Gejala klinis berat pada: • Kehamilan • abortus, • kerusakan otak janin (mental retardation), • kerusakan mata (retinochorditis) • Imunodefisiensi (immunocompromised) • Kerusakan otak, hati, paru, organ lain • Kematian penderita
DIAGNOSIS DUGAAN TOXOPLASMOSIS ISOLASI TOXOPLASMA GONDII DENGAN MELAKUKAN BIOPSI • TONSIL • KELENJAR LIMFE
PENGOBATAN • Infeksi akut: pyrimethamine atau sulphadiazine. • Spiramycin : terapi alternatif • Perempuan hamil dicegah terinfeksi toksoplasmosis dengan: • Daging mentah ditangani dengan baik • Tidak makan daging kurang matang • Hindari kontak tinja kucing
PENCEGAHAN TOXOPLASMOSIS • MASAK MAKANAN-MINUMAN • HINDARI KONTAK LANGSUNG DENGAN DAGING/ORGANMISALNYADI ABATOIRDAN PENJUAL DAGING • CUCI TANGAN/GUNAKAN SARUNG TANGAN JIKA BERKEBUN • OBATI PENDERITA MANUSIA/HEWAN • LINGKUNGAN BEBAS TINJA KUCING/HEWAN LAIN • PEMERIKSAAN IBU HAMIL