27/12/2016

Identitas Pasien

Nama
Usia
Jenis kelamin
Pekerjaan

: Ny. S
: 68 tahun
: Perempuan
: Ibu rumah tangga

Presentasi Kasus
ACINTYA SEKAR MAHARDHIKA
12/338670/KU/15329

Anamnesis
Keluhan utama: rasa terbakar dan nyeri pada tungkai bawah
Riwayar sekarang: pasien datang dengan keluhan rasa
terbakar dan nyeri pada tungkai bawah sebelah kiri, terdapat
daerah kemerahan. 2 minggu sebelum pasien datang ke
rumah sakit pasien mengeluhkan rasa gatal di tungkai bawah
sebelah kiri, luas lesi sebelumnya tidak seluas lesi yang
sekarang

Riwayat Penyakit
Riwayat Penyakit Dahulu:
Riwayat alergi (-)
Riwayat penyakit kronis: hipertensi
Riwayat Penyakit Keluarga:
Tidak terdapat keluhan serupa pada keluarga maupun lingkungan di
rumah

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Pemeriksaan Fisik
Pada tungkai bawah sebelah
kiri terdapat eritema berwarna
merah cerah, berbatas tegas.
Penggiran lesi terkesan
meninggi dengan tanda-tanda
peradangan akut

Diagnosis dan Diferensial

Diagnosis
Diferensial diagnosis: Erisipelas, selulitis, urtikaria
Diagnosis: Erisipelas

Tatalaksana dan Edukasi

Penatalaksanaan: istirahatkan dan tungkai bagian bawah di
letakkan pada posisi yang lebih tinggi
Pengobatan sistemik
analgetik antipiretik
antibiotik: penisilin 0.6 1.5 mega unit 5-10 hari; sefalosporin
4x400 mg 5 hari

Tinjauan Pustaka

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Definisi
Erysipelas is a superficial cutaneous process that is usually
restricted to the dermis, but with prominent lymphatic
involvement. It is distinguished clinically from other forms of
cutaneous infection by three features: the lesions are raised
above the level of the surrounding skin, there is a clear line of
demarcation between involved and uninvolved tissue, and the
lesions are a brilliant salmon-red color. This disorder is more
common in infants, young children, and older adults, and is
almost always caused by -hemolytic streptococci.

Pathogenesis
In erysipelas, the infection rapidly invades and spreads
through the lymphatic vessels. This can produce overlying skin
"streaking" and regional lymph node swelling and tenderness.
Immunity does not develop to the inciting organism.
Bacterial inoculation into an area of skin trauma is the initial
event in developing erysipelas. Thus, local factors, such as
venous insufficiency, stasis ulcerations, inflammatory
dermatoses, dermatophyte infections, insect bites, and
surgical incisions, have been implicated as portals of entry.
The source of the bacteria in facial erysipelas is often the
host's nasopharynx, and a history of recent streptococcal
pharyngitis has been reported in up to one third of cases.

Epidemiology
Erysipelas is somewhat more common in European countries
It has an estimated incidence of 1924 per 10,000 inhabitants
in European countries
The most common site of the infection is the lower limb,
accounting for about 80% of all cases
Erysipelas infections affect persons of all races
More common in females but to occur at an earlier age in
males

Diagnosis
Accute inflmmatory plaque with fever, lymphangitis,
adenopathy and hyperleukocytosis.
Bacteriology is not helpful for the diagnosis of erysipelas
because of a low sensitivity (homeculture) or delayed
positivity (serology)

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Tatalaksana
Penatalaksanaan: istirahatkan dan tungkai bagian bawah di
letakkan pada posisi yang lebih tinggi
Pengobatan sistemik
analgetik antipiretik
antibiotik: penisilin 0.6 1.5 mega unit 5-10 hari; sefalosporin
4x400 mg 5 hari

TERIMAKASIH