Efusi Perikardial pada Pediatrik SLE disertai Sepsis

Agung Hujjatulislam, Tinni Trihartini Maskoen

Abstract


Dilaporkan satu kasus SLE pada seorang anak perempuan berusia 11 tahun. Pasien datang dengan keluhan demam, nyeri kepala, kejang disertai dengan penurunan kesadaran, sesak napas, dan nyeri sendi. Diagnosis SLE ditegakkan dengan terpenuhinya 6 dari 11 kriteria klasifikasi SLE dari American College of Rheumatology (ACR) yaitu serositis, anemia, nefritis, kejang, serum antinuclear antibody (ANA) positif, dan anti-dsDNA yang positif. Diagnosis efusi perikardial diperoleh dari suara jantung yang menjauh, gambaran EKG yang menunjukkan adanya sinus takikardi, dan pemeriksaan ekokardiografi yang menunjukkan efusi perikardial berat (21,9 mm sirkumferensial). Ditemukannya Staphylococcus hominis (MRSA) dari kultur darah menunjang diagnosis sepsis pada pasien ini dengan skor Sequential organ failure assessment (SOFA) 3 dan quick sequential organ failure assessment (qSOFA) 2. Pasien mendapatkan terapi metilprednisolon, fenitoin, midazolam, nikardipin, dan vankomisin. Pada hari ke-8 pasien mengalami perbaikan, dan dipindahkan pada hari ke-11.

Kata kunci: Anemia, efusi perikardial,kejang, MRSA,nefritis,sepsis,systemic lupus erythematosus

Pericardial Effusion on a Pediatric SLE Patient with Sepsis

A case of systemic lupus erythrematosus (SLE) in a 11-year-old girl was reported. Patient was admitted to hospital with fever, headache, seizure with loss of consiousness, shortness of breath, and joint pain. The patient fulfill 6 out of 11 American College of Rheumatology classification criteria for SLE, which are serositis, anemia, nephritis, seizures, positive ANA serum, and positive anti-dsDNA. Diagnosis of pericardial effusion was based on muffled heart sound, sinus tachycardia on ECG, and echocardiography examination that showed severe pericardial effusion (21.9 mm circumferential). Staphylococcus hominis (MRSA) found on blood culture supported the diagnosis of sepsis with SOFA score 3 and qSOFA score 2. The patient received methylprednisolone, phenytoin, midazolam, nicardipine, and vancomycin. On the 8th day the patient was improving, and was transferred on the 11th day.

Key words: anemia, MRSA, nephritis, pericardial effusion, seizures, sepsis, systemic lupus erythrematosus


Keywords


Anemia, efusi perikardial,kejang, MRSA,nefritis,sepsis,systemic lupus erythematosus

Full Text:

PDF

Refbacks

  • There are currently no refbacks.


Copyright (c) 2019 Majalah Anestesia dan Critical Care


View My Stats