VALIDITY SHEET

Case Presentation

The Role of Procalcitonin for Diagnosing Bacterial Infection In Leukemic Fever: An

Evidence-Based Case Report

This case report is written by

Rahmanu Reztaputra
Resident of Internal Medicine
Faculty of Medicine
Universitas Indonesia

This case report has been approved and to be presented

in Cipto Mangunkusumo Hospital
December 2019

Supervisor Chief of Ward

Dr. dr. Widayat Djoko Santoso, SpPD-KPTI dr. Mustika Dian Permana

i
Universitas Indonesia
 ANTI-PLAGIARISM STATEMENT

I, who undersigned below, truthfully declare that this evidence-based case report entitled:

The Role of Procalcitonin for Diagnosing Bacterial Infection In Leukemic Fever: An

Evidence-Based Case Report

is written without plagiarism action, accordance with the regulations in the Universitas
Indonesia.
If someday, I can be proven to perform actions that are classified as plagiarism, I will take
full responsibility and I will accept the sanctions imposed by Universitas Indonesia to me.

Jakarta, December 2019

Dr. Rahmanu Reztaputra

ii
Universitas Indonesia
 INVITATION

Evidence-Based Case Report presentation, entitled:

The Role of Procalcitonin for Diagnosing Bacterial Infection In Leukemic Fever: An

Evidence-Based Case Report

Presented by : dr. Rahmanu Reztaputra

Chief of Ward : dr. Mustika Dian Permana
Supervisor : Dr. dr. Widayat Djoko Santoso, SpPD-KPTI.

Would like to invite:

Moderator : The Head of Infection and Tropical Medicine Division,
Dept of Internal Medicine, Faculty of Medicine Universitas Indonesia-
Cipto Mangunkusumo Hospital
Source person : The Staff of Infection and Tropical Medicine Division,
Dept of Internal Medicine, Faculty of Medicine Universitas Indonesia-
Cipto Mangunkusumo Hospital
The Staff of Hematology and Oncology Division,
Dept of Internal Medicine, Faculty of Medicine Universitas Indonesia-
Cipto Mangunkusumo Hospital
The Staff of Dept of Clinical Pathology, Faculty of Medicine
Universitas Indonesia-Cipto Mangunkusumo Hospital

Approved by

Dr. dr. Widayat Djoko Santoso, SpPD-KPTI

iii
Universitas Indonesia
 TIME TABLE OF CONSULTATION

Supervisor

Date Activity Signature

December 20TH 2019 Final approval

Chief of ward

Date Activity Signature

November 20th 2019 First revision

December 15th 2019 Second revision

December 20th 2019 Final approval

iv
Universitas Indonesia