Kelompok 2

Skenario 1

Mind MapFever, cough, runny nose, sore throat

laringitis

faringitis

tonsilitis

rinitis

Patogenesis, etiologi, manifestasi, diagnose

L.O. rinitis Faringitis Tonsislitis Laringitis

Sinusitis Akut is a result of impaired mucociliary clearance and obstruction of the osteomeatal complex. The maxillary sinus, the largest of the paranasal sinuses, is the most commonly affected sinus Etiology: virus, rhinitis, ostio-meatal obstruction, tonsil & dental infection, etc

Symptoms and Signs Subjectif: systemic Fever

Local: Nasal obstruction. Sinus pain nasal discharge

Obsjective Facial edema Rinoscope anterior Edema & mucosa hiperemi Mucopus at meatus media or superior

Rinoscope posterior Post nasal drip

Laringitis Etiology rhinovirus, influenza virus, parainfluenza virus, adenovirus, coxsackievirus, coronavirus, and RSV group A Streptococcus or C. diphtheriae

PathophysiologyWhen the etiology of laryngitis is infectious WBC remove microorganisms during the healing process the vocal folds edematous & vibration is adversely affected The phonation threshold pressure may increase to a degree that generating adequate phonation pressures in a normal fashion becomes difficult, thus eliciting hoarseness.

Clinical Manifestations hoarseness and can also be associated with reduced vocal pitch or aphonia rhinorrhea, nasal congestion, cough, and sore throat Direct laryngoscopy often reveals diffuse laryngeal erythema and edema

Acute Pharyngitis

Etiology Viruses Adenoviruses Coronaviruses Enteroviruses Rhinoviruses Respiratory Sncytial Virus (RSV) Epstein Barr Virus (EBV) Herpes Simplex Virus (HSV) Group A Beta-Hemolytic Streptococcus Group C Streptococcus Arcanobacterium haemolyticum Corynebacterium diphtheria ect,

Bacteria

Epidemiology Infection are spread by close contact Occur most commonly in fall, winter, and spring Streptococcal pharyngitis is uncommon before 2-3 yr of age, peak incidence in erly school years group C streptococcus and A. Haemolyticum occurs most frequently among adolescents and adults

Pathogenesis Colonisasi GBHS in pharynx M-protein, the major virulence factor of GBHS M-protein facilitates resistance to phagocyte by PMN The body make thype-specifik immunity protecting to subsequent infection

Clinical ManifestationsStreptococcal pharyngitis Prominent sore throat Absence of cough Fever Headache Gastrointestinal symptoms (abdominal pain, vomiting) are frequent The pharynx is red, and the tonsils are enlarged Viral pharyngitis Rhinorrhea Cough Diarrhea Conjunctivitis Hoarsenes Fever Prominent tonsillar enlargement with exudat

Diagnosis The goal of specific diagnosis is to identify GABHS infection Rapid tes antigent Throut culture (imperfect gold standar)

PCR (expensive) A complete blood cell (CBC) count (diagnosis EBV infection)

Rhinitis Rhinitis is an upper respiratory tract infection with mild symptoms of clogged nose principal, the nasal secretions, sneezing, sore throat and cough Etiology rhinovirus , virus parainfluenza, RSV, Adenovirus

Symptom Prodromal stage : feeling hot , dry, and itchy in the nose (several hours) Hyperemia stage : red and swollen nasal mucosa , repeated sneezing, nasal congestion, runny nose and watery , fever and headache Stage of secondary infection : secretions become thick (mucopurulent) Resolution stage : 5-10 days

Therapy - Symptomatic - Secondary infection antibiotics Complications - Sinusitis - Otitis media - Faringitis - Bronchitis dan pneumonia

Scenario Analysis Name : Mr/Mrs Y Chief Complaint : Fever, cough and Runny nose since three days before Present History : the child also have pain swallowing and since yesterday she had sore throat. Physical examination: Underweight, vital sign are normal, chest is clear , heart sound normal, inflammation signs of the pharynx & tonsil, and enlargement of lymph nodes

DD : Rhinitis & Tonsilofaringitis Treatment : Supportive Treatment : drink more water Symptomatic Treatment : Dekongestan, asetaminofen prescribing antibiotics to patients is irrational because it has not been in a phase of secondary infection