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    DD fever

    By

    Gatut Wicaksono(04020013)

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    Main causes of fever

    Infections (Bacterial, virus, TB, parasitic,

    rickettsia) are by far the most common cause

    of fever in children. Infection remains the

    likely diagnosis in a febrile child until proven

    otherwise.

    Noninfectious (collagen/vascular, malignancy,

    drugs, allergy, recent immunization, periodicfevers).

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    Diagnosis that fever is caused by an

    infection is supported by the following:

    Underlying conditions predisposing to infections (e.g.,Immunocompromised status, splenectomy, sickle cell anemia,neonates and young infants, intravascular catheters)

    Fever of 40C or greater, presence of chills, diurnal fluctuation offever

    A focus for infection (e.g., tonsillitis, pneumonia). In case of feverwithout a focus, the diagnosis can usually be rapidly established bylaboratory means (e.g., UTI, malaria)

    Short duration of fever occuring, for example, in viral infections

    Rapid response to antibiotics in bacterial infections

    Concomitant herpes labialis Leukocytosis >20,000 in bacterial and leukopenia < 5,000 in viral

    infections

    High procalcitonin (PCT) levels. PCT is low in viral infections andinflammatory diseases, for example, connective diseases andneoplasma

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    Diagnosis that fever is not caused by an

    infection is supported by the following:

    History (e.g., recent vaccination, drug intake)

    Persistent or insidious fever of low degree (

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    DDX Perbedaan

    (Tipe demam)

    Gejala Pemeriksaan Terapi

    Relapsing Fever(Borrelia)

    characterized byperiods of fever

    lasting 29 days,

    separated by

    afebrile periods

    of 27 days

    sudden onset ofhigh fever,

    lethargy,

    headache,

    photophobia,

    nausea,

    vomiting,myalgia, and

    arthralgia

    Additional

    symptoms:

    abdominal pain,

    a productivecough, and mild

    respiratory

    distress

    thin or thickblood smears

    stained with

    Giemsa or

    Wright's stain.

    Oral orparenteral

    tetracycline is the

    drug of choice

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    Daftar Pustaka

    A. Sahib El-Radhi,James Carroll,Nigel

    Klein.2009.Clinical Manual of Fever in

    Children. Springer: Verlag Berlin Heidelberg

    Powell,Keith R.2003.Nelson Textbook of

    Pediatrics 17th edition:Fever.Elsevier

    Science:USA