Cr Kelompok 1

8/19/2019 Cr Kelompok 1

1/17

BAGIAN ILMU PENYAKIT DALAM

FAKULTAS KEDOKTERAN UNILA

RSU JENDRAL AHMAD YANI METRO

PRESENTASI KASUS

ANEMIA APLASTIK, FEBRILE NEUTROPENI, DHF,

HT URGENCY

Jumat, 1 Oktobe !"1#

O$e%

• A&u Le'ta( N 1#1)"1!1!" ,

• Gu$bu**(+ %(kmat&a 1#1)"1!1!,

• Na(ta Eka+a+*a 1#1)"1!1!-,

•Re't( Ram*a+( 1#1)"1!1!.,

• Sat(a D%ama S 1#1)"1!11.

Pemb(mb(+/ 0 * Ro+a$* Da2(* Matua, S3 PD

Pendahuluan

Me$a3oka+ 'eoa+/ 4a+(ta &a+/ *ata+/ *e+/a+ ke$u%a+ $ema% ba*a+ *a+ *(buat *(a/+o'a

a+em(a a3$a't(k, 5eb($e +euto3e+(a, *e+/ue %emoa/(6 5e2e, 3o$a3' ute(, *a+ HT u/e+6& Sebe$um

ma'uk RSUD Je+*a$ A%ma* Ya+( 3e+*e(ta 'u*a% me+7a$a+( 3e+/obata+ *( K$(+(k *a+ 3e+*e(ta

t(*ak me+/a$am( 3eba(ka+, 3e+*e(ta *(*(a/+o'a *e+/a+ a+em(a *a+ 2(a$ (+5e6t(o+ Pe'e+ta'( ka'u'(+( aka+ me+7e$a'ka+ te+ta+/ a$u 3e+e/aka+ *(a/+o'a *a+ 3e+ata$ak'a+aa++&a

Lapoan !a"u"

Pe+*e(ta a*a$a% 'eoa+/ 4a+(ta beu'(a -. ta%u+, te$a% me+(ka% *a+ mem3u+&a( 8 oa+/

a+ak *a+ t(*ak a*a (4a&at ke/u/ua+ 'ebe$um+&a Pe+*e(ta *ata+/ ke UGD RSUD A%ma* Ya+(

3a*a ta+//a$ !9 A/u'tu' !"1# *e+/a+ ke$u%a+ utama $ema% ba*a+ 'e7ak 1 %a( SMRS Lema% ba*a+

3a'(e+ %(+//a t(*ak b('a u+tuk be7a$a+ ke kama ma+*( 'e+*((a+ *a+ %au' a*a &a+/ me+*am3(+/(

Ke$u%a+ 'emak(+ %a( 'emak(+ membeat Demam &a+/ *(a'aka+ 'e7ak 1 %a( SMRS, 'u%u

me+(+/kat 3a*a 'oe %(+//a ma$am %a( Da+ 'u%u me+6a3a( 'u%u +oma$ 3a*a 3a/( %a( %(+//a '(a+/

%a( Ket(ka *emam t(+//( 3e+*e(ta me+/e$u%ka+ me+//(/($ *a+ *('eta( ke(+/at *(+/(+ Da+

3e+*e(ta me+/a$am( +&e( 3a*a ba/(a+ ab*ome+ *a+ 3e+*e(ta t(*ak *a3at me+//ambaka+ $oka'(

+&e( ab*ome+, 'emak(+ membeat 'e7ak 1 m(+//u teak%(, +&e( ab*ome+ t(*ak *(3e+/au%( *e+/a+

4aktu maka+ Mua$ mu+ta% *(a'aka+ 3a'(e+ 'e7ak 'ebe$um ma'uk uma% 'ak(t, mu+ta% a( *('eta(

am3a' maka+a+ Pa'(e+ mea'a 'e'ak 'e7ak 'b$m ma'uk uma% 'ak(t, 3a'(e+ $eb(% 'e(+/ *a+ $eb(%

+&ama+ b($a t(*u m((+/ ke ka+a+ BAB *a+ BAK t(*ak a*a ke$u%a+ Pe+*e(ta mem3u+&a( (4a&at

%(3ete+'( *a+ *(abete' m($(tu' Pa'(e+ t(*ak mem3u+&a( m(+um obat atau 7amu:7amua+ ut(+

1


2/17

Kea*aa+ umum 0 tam3ak 'ak(t 'e*a+/

Statu' /(;( 0 kua+/, BMI 0 !! 1"" mmH/, +a*( )" ?>me+(t e/u$a e@ua$ ('( 6uku3, 3e+a5a'a+ !

?>me+(t t(*ak *a$am, 'u%u 9),!"

Ke3a$a 0 +omo6%e3a$, 3e+&ebaa+ ambut +oma$, ambut t(3(' *a+ t(*ak mu*a% o+tok a7a%

'(met(', ko+7u+/t(2a a+em(', t(*ak a*a (kte(k, t(*ak a*a 3e+a5a'a+ 6u3(+/ %(*u+/ Pu3($ *(amete 9

mm bu$at ('ok%o, e5$ek' 6a%a&a


3/17

A$bum(+ !,#8

IDAL

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A+t( De+/ue I/M, I/G!.>)

A+t( De+/ue I/M Po'(t(5

A+t( De+/ue I/G Po'(t(5

!>)>!"1#

Foto 3o$o' Ab*ome+ AP 2(e4

• Meteo('mu'

• Le'( o3ak bu$at *(3o&ek'( 3aa2etebae *e?ta 'et(+//( L ! 'u'3e6t +e5o$(t(a'(' *e?ta

• Tak tam3ak 3+eumo3e(to+eum

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USG ab*ome+

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• Tak tam3ak ke$a(+a+ 3a*a %e3a, F, $(e+, 3a+6ea'

>8>!"1#

BMP

• Ga+//ua+ %(3e'e$u$e kae+a akt(2(ta' e(to3o(e'(' 'a+/at me+(+/kat et 6au'a *e5('(e+'(

be'(>%emo$(t(k>ek'a'eba'( akut> 3a'6a *e5('e+'( be'(> (+5ek'( akut> beat

D$a&no"a !e%a dan d$a&no"a 4and$n&

Be*a'aka+ *ata:*ata *(ata' 3e+*e(ta *(buat *(a/+o'a 'eba/a( be(kut0

D(a/+o'a ke7a 0 A+em(a A3$a't(k, Feb($e Neuto3e+(a, DHF, H(3ete+'( U/e+'(

D(a/+o'(' ba+*(+/ 0 A+em(a *e5('(e+'( be'(, $eukem(a, t%&3o(*, ma$a(a

Pena'ala!"anaan

Pe+*e(ta me+*a3atka+ tea3( +ut('( *(et $u+ak 1!"" kka$>%a( , *e+/a+ ka*u+/a+ 3ote(+ 1

/am>k/BB t(+//( ka$(um, (+5u' RL 1""" 66> ! 7am, KSR tab$et !?-"" m/ 3o, 'e$a+7ut+&a 3e+*e(ta

*($akuka+ 3eme(k'aa+ e$ekto$(t 3o't koek'( Me+*a3at koek'( Ma/+e'(um *e+/a+ M/SO *(3 !

9


4/17

/ 3a*a %a( 3ea4ata+ ke :1" Pe+*e(ta kemu*(a+ *(3a'a+/ P 3a*a %a( 3ea4ata+ ke:9 u+tuk

me+($a( 'tatu' %(*a'( kae+a te*a3at 3o$(u(

Pe+*e(ta me+*a3atka+ tea3( 6a$o' tab$et 9?1, 2(5eo+ 1?1, *a+ 'em3at me+*a3at tea3(

'teo(*, 3e*+('o+ *a( %a( 3ea4ata+ ke*e$a3a+ 'am3a( e+am be$a' u+tuk meete+'( Na *a+ a(, *a+

me+*a3at obat B kom3$ek' 9?1, 3e+*e(ta 7u/a *($akuka+ 3eme(k'aa+ e$ekto$(t 3o't koek'(, u(+e

ut(+, e$ekto$(t u(+e, EKG *a+ USG /(+7a$

Kon"ul'a"$

Se$a+7ut+&a 3e+*e(ta *(ko+'u$ka+ ke 'ub:ba/(a+ ob'tet( *a+ /(+eko$o/( u+tuk *(a/+o'a *a+

3e+ata$ak'a+aa+ 3o$a3' ute(

Follo5 Up

Ha$ pea5a'an pe'a#a

Ke$u%a+ $ema% ba*a+ *(a'aka+ 'emak(+ membeat, *emam +a(k tuu+ teta3 *(a'aka+ *('eta(

*e+/a+ ke$u%a+ mua$ mu+ta% *a+ te*a3at 3embe+/kaka+ 3a*a 'e$uu% ek'tem(ta' Pe+*e(ta 'aat

(+( te$a% me+*a3at e%(*a'( RL !""" 66>%a(, 6e5o3oa;o+e !?1, 'o%ob(o+ 9?1, ome3a;o$e 1?1,

o+*a+'e+to+ !?1, 3aa6etamo$ 9?1 *a+ meto+(*a;o$ 9?1

Ha$ pea5a'an !e(*

Ke$u%a+ $ema% $ema% ba*a+ teta3 *(a'aka+, *emam ma'(% +a(k tuu+, te*a3at ke$u%a+ 'u'a% 'aatBAK Pe+*e(ta ma'(% me+*a3at tea3( 3e+/obata+ &a+/ 'ama 3a*a %au 3etama

Ha$ pea5a'an !e( .(/

Pe+*e(ta teta3 mea'aka+ $ema% ba*a+ *a+ *emam *('eta( mua$ mu+ta%, te*a3at 3embe+/kaka+

3a*a 'e$uu% ek'tem(ta' *a+ *('eta( *e+/a+ ke$u%a+ 'ak(t 'aat BAK, 3e+*e(ta 'e(+/ 'e'ak 'aat

me+/a$am( *emam 3a+a' t(+//( Peut tea'a 'ak(t 3a*a 'e$uu% ba/(a+ *a+ 'ak(t betamba% 3a*a 'aat

*(teka+ Ta+*a:ta+*a 2(ta$ 3a*a 3e+*e(ta 'tab($ 3a*a 'aat 3eme(k'aa+ 3a/( %a( Pe+*e(ta

*(3a'a+/ka+ katete u+tuk memba+tu 3e+/e$uaa+ u(+e Pa*a %a( ke:- 3e+*e(ta *(be(ka+ tea3(

Am(+o5$u(* 1#"" 66>%a(

Ha$ pea5a'an !e( 0 ( 3

Pe+*e(ta me+/a$am( $ema% ba*a+ &a+/ 'emak(+ membuuk *a+ *emam 'amak(+ me+(+//( 'aat

ma$am %a( &a+/ 'eta( ke(+/at *(+/(+, me+//(/($ *('eta( 'e'ak +a3a'


5/17

Ha$ pea5a'an !e )2()*

Ke$u%a+ $ema% ba*a+ *(a'aka+ 'u*a% bekua+/, *emam ma$am %a( 'emak(+ memba(k 'e'ak 'u*a%

bekua+/, *a+ BAK 'u*a% $a+6a kemba$( *a+ *($akuka+ 3e+6abuta+ katete

Re"u#e

Seoa+/ 4a+(ta u'(a -. ta%u+ *ata+/ ke uma% 'ak(t *e+/a+ ke$u%a+ $eta/( *a+ *emam

ko+(', ke$u%a+ t(*ak 3e+a% *(a'aka+ 'ebe$um+&a N&e( 'e$uu% $a3a+/ ab*ome+ 2om(t(+/,

+au''ea, *('3+ea *a+ tak te*a3at ke$u%a+ 3a*a BAB *a+ BAK Pe+*e(ta 'u*a% 3e+a% *(a4at

'e$ama 1 m(+//u *( k$(+(k 'etem3at *a+ t(*ak te*a3at 3eba(ka+ 'e%(+//a *(u7uk ke uma% 'ak(t

Leta/( *(a'aka+ 'emak(+ $ama 'emak(+ membuuk *a+ 5eb(' t(*ak memba(k T(*ak te*a3at (4a&at

ko+'um'( obat:obata+ 'ebe$um+&a Pa*a 3eme(k'aa+ 5('(k *(*a3atka+ teka+a+ *aa% &a+/

me+(+/kat, 'u%u tubu% me+(+/kat, te*a3at ko+7u+/t(2a a+em(', a*a+&a 3ebe'aa+ %e3a *a+ +&e(

teka+ 3a*a ba/(a+ ab*ome+ Pa*a ek'tem(ta' te*a3at 3(tt(+/ oe*ema

Peme(k'aa+ $aboato(um *aa% ut(+ me+u+7ukka+ 3e+uu+a+ 3a*a 7um$a% $euko'(t ",--

(bu>uL, e(to'(t !,8) 7uta>uL, tombo'(t #. (bu>uL *a+ %emo/$ob(+ ),1 />m$, +euto5($ 'e/me+ ",

+euto5($ bata+/ ", a$bum(+ !,#8, 3eme(k'aa+ IDAL me+u+7ukka+ %a'($ +e/at(5, 3eme(k'aa+ I/G

*a+ I/M a+t( *e+/ue %a'($ 3o'(t(5, 3eme(k'aa+ 5oto 3o$o' ab*ome+ *(*a3atka+ %a'($ meteo('mu',

USG ab*ome+ me+u+7ukka+ e5u'( 3$eua *e?ta t(*ak tam3ak ke$a(+a+ 3a*a %e3a, F, $(e+, 3a+kea',

'e$a+7ut+&a 3a*a 3a'(e+ *($akuka+ 3eme(k'aa+ BMP *a+ *(*a3atka+ %a'($ /a+//ua+ %(3e'e$u$e

kae+a akt(2(ta' e(to3o(e'(' 'a+/at me+(+/kat e6 *e5('(e+'( be'(>%emo$(t(k>ek'a'eba'( akut>3a'6a

*e5('(e+'( be'(> (+5ek'( akut atau beat Sete$a% *emam me+uu+ 'e$ama ! %a( kea*aa+ umum

memba(k, t(*ak te*a3at ta+*a:ta+*a 3e*aa%a+, kea*aa+ umum memba(k, 'e'ak t(*ak *(a'aka+,

+a5'u maka+ memba(k 3a*a %a( ke 1! 3a'(e+ *(3ebo$e%ka+ u+tuk 3u$a+/

Pe#4aha"an dan d$"!u"$

Pema'a$a%a+ 3a*a 3e+*e(ta (+( a*a$a% 0

• A3a *(a/+o'a ba+*(+/ $ema% ba*a+ *a+ *emam 3a*a 3e+*e(ta (+(

• Ba/a(ma+a me+e/akka+ *(a/+o'a 3a*a 3e+*e(ta (+(

Apa d$a&no"a 4and$n& le#ah 4adan dan de#a# pada pende$'a $n$6

Pe+*e(ta a*a$a% 'eoa+/ 4a+(ta beu'(a -. ta%u+, te$a% me+(ka% *a+ mem3u+&a( 8 oa+/

a+ak *a+ t(*ak a*a (4a&at ke/u/ua+ 'ebe$um+&a Pe+*e(ta *ata+/ ke UGD RSUD A%ma* Ya+(

3a*a ta+//a$ !9 A/u'tu' !"1# *e+/a+ ke$u%a+ utama $ema% ba*a+ 'e7ak 1 %a( SMRS Lema% ba*a+

3a'(e+ %(+//a t(*ak b('a u+tuk be7a$a+ ke kama ma+*( 'e+*((a+ *a+ %au' a*a &a+/ me+*am3(+/(

#


6/17

Ke$u%a+ 'emak(+ %a( 'emak(+ membeat Demam &a+/ *(a'aka+ 'e7ak 1 %a( SMRS, 'u%u

me+(+/kat 3a*a 'oe %(+//a ma$am %a( Da+ 'u%u me+6a3a( 'u%u +oma$ 3a*a 3a/( %a( %(+//a '(a+/

%a( Ket(ka *emam t(+//( 3e+*e(ta me+/e$u%ka+ me+//(/($ *a+ *('eta( ke(+/at *(+/(+ Da+

3e+*e(ta me+/a$am( +&e( 3a*a ba/(a+ ab*ome+, 'emak(+ membeat 'e7ak 1 m(+//u teak%(

Pe+*e(ta mem3u+&a( (4a&at %(3ete+'( *a+ 3e+*e(ta be$um 3e+a% me+/a$am( /e7a$a:/e7a$a

te'ebut 'ebe$um+&a

Lema% ba*a+ &a+/ *(a'aka+ 'e'eoa+/ *a3at *('ebabka+ o$e% a+em(a, %(3o/$(kem(a, %(3et(o(*, *a+

*e%(*a'( Pa*a a+em(a $ema% ba*a+ *('ebabka+ o$e% ku(a+/+&a 7um$a% %emo/$ob(+ *a$am *aa%

'e%(+//a a'u3a+ ok'(/e+ *a$am tubu% bekua+/, ok'(/e+ u+tuk *(3e$uka+ u+tuk 3embakaa+ e+e/(

7a*( 3a*a a+em(a e+e/( &a+/ *(butu%ka+ o$e% otot bekua+/ 'e%(+//a ba*a+ tea'a $ema% A+em(a

teba/( ata' bebea3a 7e+(', 'a$a% 'atu+&a *a$a% a+em(a a3$a't(k

A+em(a a3$a't(k a*a$a% 'uatu /a+//ua+ 3a*a 'e$:'e$ (+*uk *( 'um'um tu$a+/ &a+/ *a3at

me+(mbu$ka+ kemat(a+, 3a*a kea*aa+ (+( 7um$a% 'e$:'e$ *aa% mea% &a+/ *(%a'($ka+ t(*ak mema*a(

Pe+*e(ta me+/a$am( 3a+'(to3e+(a &a(tu kekua+/a+ 'e$ *aa% mea%, *a+ tombo'(t

A+em(a a3$a't(k 7u/a b('a *(at(ka+ 'eba/a( 'uatu ke/a/a$a+ a+atom( *a+ 5('(o$o/( *a(

'um'um tu$a+/ &a+/ me+/aa% 3a*a 'uatu 3e+uu+a+ +&ata atau t(*ak a*a+&a u+'u

3embe+tuk *aa% *a$am 'um'um Ha$ (+( k%a' *e+/a+ 3e+uu+a+ 3o*uk'( e(to'(t ak(bat

3e/a+t(a+ *a( u+'u 3o*uk'( e(to'(t *a$am 'um'um o$e% 7a(+/a+ $emak %(3o'e$u$e, 7u/a

*a3at mem3e+/au%( me/aka&o'(t me+/aa% 3a*a +euto3e+(a

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atau %($a+/, *a+ b(o3'( 'um'u+/ tu$a+/ me+u+7ukka+ 'uatu kea*aa+ &a+/ *('ebut 3u+/'( ke(+/

*e+/a+ %(3$a'(a &a+/ +&ata *a+ te7a*( 3e+//a+t(a+ *e+/a+ 7a(+/a+ $emak

Pe+&ebab:3e+&ebab a+em(a a3$a't(k 0

1 Fakto ko+/e+(ta$

S(+*om 5a+6o+( &a+/ b(a'a+&a *('eta( ke$a(+a+ ba4aa+ $a(+ 'e3et( m(ko'e5a$(, 'tab('mu',

a+oma$( 7a(, ke$a(+a+ /(+7a$ *a+ 'eba/a(+&a

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a Ba%a+ k(m(a, be+;e+e, (+'ekt('(*a, 'e+&a4a A', Au, Pb

b Obat 0 K$oam5e+(ko$, Me'a+to(+


7/17

e I+5ek'(, ke/a+a'a+, /a+//ua+ e+*ok(+

5 La(+$a(+ 0 3e+&ak(t /(+7a$

/ I*(o3at(k 0 meu3aka+ 3e+&ebab &a+/ 3a$(+/ 'e(+/, ak%(ak%( (+( 5akto (mu+o$o/('

te$a% *a3at me+ea+/ka+ et(o$o/( /o$o+/a+ (*(o3at(k

Ma+(5e'ta'( K$(+(k

1 Pu6at

! Ke$ema%a+

9 Se'ak +a5a'

Ruam

# Mu*a% $ebam

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11 U$'ea'( mu$ut *a+ 5a(+/

1! Pe*aa%a+ ke *a$am te+/koak, /u'(, u'u' atau /(+7a$

D(a/+o'a ba+*(+/ *emam 3a*a 3a'(e+ (+( a*a$a% *emam *e+/ue Demam *e+/ue a*a$a%

3e+&ak(t &a+/ *('ebabka+ o$e% 2(u' *e+/ue 'e7e+(' 2(u' &a+/ te/o$o+/ arbovirus

(Arthropod-borne viruses) at(+&a 2(u' &a+/ *( tu$aka+ me$a$u( /(/(ta+ arthropoda m('a$+&a

+&amuk aedes aegypti


8/17

D(a/+o'a ba+*(+/ $a(+ 3a*a *emam &a+/ *(a$am( 3a'(e+ a*a$a% *emam t%&3o(* &a+/

meu3aka+ *emam kae+a (+5ek'( bakte( !almonella thypii, !almonella para typhi A, "

*a+ # A*a *ua 'umbe 3e+u$aa+ !almonella thypii &a(tu 3a'(e+ *e+/a+ *emam t&3%o(*

*a+ 3a'(e+ *e+/a+ 6a(e #arier a*a$a% oa+/ &a+/ 'embu% *a( *emam t&3%o(* *a+

ma'(% teu' me+/eke'( !almonella thypii *a$am t(+7a *a+ a( kem(% 'e$ama $eb(% *a( 1

ta%u+

!almonella $hyposa meu3aka+ ba'($ /am +e/at(5 &a+/ be/eak *e+/a+ bu$u /eta, t(*ak

be'3oa

Ma'a (+kuba'( t&3%o(* 1":!" %a( K$(e+ b(a'a+&a me+/e$u% +&e( ke3a$a *a+ te$(%at $ema%

*a+ $e'u *('eta( *emam &a+/ t(*ak te$a$u t(+//( *a+ be$a+/'u+/ 'e$ama 9 m(+//u

M(+//u 3etama 3e+(+/kata+ 'u%u tubu% +a(k tuu+ B(a'a+&a 'u%u tubu% me+(+/kat 3a*a

ma$am %a( *a+ me+uu+ 3a*a 3a/( %a( Pa*a m(+//u ke*ua 'u%u tubu% teu' me+(+/kat *a+

3a*a m(+//u ket(/a 'u%u bea+/'u:a+/'u tuu+ *a+ kemba$( +oma$

Pa*a /a+//ua+ *( 'a$ua+ 3e+6e+aa+, te*a3at +a3a' bebau t(*ak 'e*a3, b(b( ke(+/ *a+ 3e6a%:3e6a%


9/17

Ga#4a ) alu d$a&no"'$!

Lema% ba*a+

H(3et(o(* A+em(a

De5('(e+'( e+e/(

metabo$(k

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Paa$&'('

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Ko+/e+(ta$Loo'(+/ taktu'

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u(+a(u'E+*ok(+

8

DEMAM

Demam

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I+tem(te+

Demam

Se3t(k> He3t(k Demam

uot(*(a+

Demam

Doub$euot(*(a+

t(5o(* (u' *a+ bakte(


10/17

D(a/+o'a ba+*(+/ $a(+ 'eba/a( 3e+&ebab %(3oka$em(a 3a*a 3e+*e(ta (+( a*a$a% ak(bat *a(

ke%($a+/a+ ka$(um me$a$u( 'a$ua+ 6e+a Be*a'aka+ $(teatu ke7a*(a+ %(3oka$em( teutama b($a

te*a3at ke%($a+/a+ me$a$u( 'a$ua+ 6e+a ba/(a+ ba4a% %a(, t(*ak a*a *(ae Namu+ 3a*a 3eme(k'aa+ ka$(um

u(+e *(*a3atka+ ka*a ka$(um u(+e &a+/ t(+//(, 'e%(+//a kemu+/k(+a+ ke%($a+/a+ ka$(um me$a$u(

'a$ua+ maka+ *a3at *('(+/k(ka+

Ke%($a+/a+ ka$(um me$a$u( 'a$ua+ u(+e *a3at *(3a%am( me$a$u( a$u *(a/+o't(k 'eba/a(

be(kut 0

Gamba ! Pe+*ekata+ H(3oka$em(a

1"

b(5a'(k ekue+ Re$a3'(+/ 5e2e*a+ *emam

3e(o*(k

Po$o+/e

5e2e U+*u2u$a+t

5e2e

DBD ma$a(a


11/17

Pe+*e(ta (+( te$a% *($akuka+ 3eme(k'aa+ ka*a ka$(um u(+e *a+ *(*a3atka+ %a'($ 'ebe'a

18" $a$u *(3e(k'a TTKG


12/17

Ba&a$#ana #ene&a!!an d$a&no"a le#ah 4adan dan de#a# pada pende$'a $n$ 7

Peme(k'aa+ $aboato(um u+tuk a+em(a a3$a't(k

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be'ema+/at 'eta +a5'u maka+ bekua+/


13/17

t(*ak a*a kom3$(ka'( atau (+5ek'( 'eku+*e O$e% kae+a (tu 3eme(k'aa+ 7um$a%

$euko'(t t(*ak be/u+a u+tuk *(a/+o'a *emam t&3%o(*

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b Saat 3eme(k'aa+ 'e$ama 3e7a$a+a+ 3e+&ak(t

B(aka+ *aa% te%a*a3 !almonella thypii teutama 3o'(t(5 3a*a m(+//u 3etama

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U7( 4(*a$ a*a$a% 'uatu eak'( a/$ut(+a'( a+taa a+t(/e+ *a+ a+t(bo*(


14/17

Be'a t(te a+t(bo*( u+tuk *(a/+o'(' *emam t(5o(* *( $+*o+e'(a be$um te*a3at

ke'e'ua(a+ Da( %a'($ bebea3a 3e+e$(t(a+ me+u+7ukka+ ba%4a ke/u+aa+ u7( (*a$

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# Peme(k'aa+ Tube?

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$eb(% *(+( a*a$a% me+*etek'( a+t(/e+ '3e'(5(k *a( kuma+ !almonella


15/17

O8= me$a$u( 3eme(k'aa+ I/M A+t( Sa$mo+e$$a


16/17

DAFTAR PUSTAKA

1 He$mut G Re++ke, Ba*$e& M De+ke A6(* Ba'e P%&'(o$o/( a+* Metabo$(k A$ka$o'(' I+

Re+a$ Pat%o3%&'(o$o/& T%e E''e+t(a$' L(33(+6ott ($$(am' ($k(+' 7b(o6e$!""#"1""!

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17/17

1.

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