kuliah zoonosis new.ppt
TRANSCRIPT
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dr. Uun Khusnul Khotimah, SpKK
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● Zoonosis : skin disease caused by various parasites
● This disease is often found in :o Crowded areaso Low socio-economic conditiono Poor sanitation and hygiene
● In the eradication effort, these attempts are needed: ◦ Early diagnosis and prompt treatment ◦ Public health education about : - Prevention - Proper hygiene - Reservoir-host-vector control
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The causes of this disease are divided into 3 major groups :
1. PROTOZOA : - Amoebiasis - Trichomoniasis
2. NEMATODA : - Oxyuriasis / enterobiasis - “Ground itch” - Cutaneous larva migrans
- Current larva - Filariasis - Dracunculiasis
3. ARTROPODA : - Scabies - Pediculosis
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● Causative agent : Ancylostoma braziliensis,
Ancylostoma caninum, &
Uncinaria stenocephala
● Mostly affects children, miners and farmers.
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Pathogenesis : Adult hookworm in dogs’ / cats’ small
intestines ↓ Eggs (in animal faeces) ↓ Rhabditiform larvae (soil) ↓ Filariform larvae (soil) ↓ penetrate
The skin ↓
“Creeping eruption”
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Clinical features :
- Common locations are on the buttocks, feet, & hands.
- The diameter of the lesion is 1 – 4 mm, red in color, a bit raised, like a coiled thread.
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7Typical track of CLM located on plantar aspect of foot.
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8Vesiculobullous lesion of CLM.
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● Diagnosis : typical lesion manifestation
● Treatment : ○ Topical :
- Classic : Chlorethyl spray, CO2, liquid N2
- Thiabendazole 10%- Albendazole 2%
○ Systemic : - Thiabendazole 25 mg/kgBW/day → 2
days- Albendazole 50 mg/kgBW/once a week
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● Method of transmission :- Direct → handshake, sexual contact- Indirect → through objects
● Etiology : Sarcoptes scabiei var hominis
Life cycle : Female mites in stratum corneum ↓
Eggs ↓ 3–4 days
Larvae 10–14 ↓ days
Mites
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Clinical features :
- Predilection : in-between fingers, flexor of the wrists, genitalia, axillae folds, lower abdomen,
buttocks.
- Lesion → papule, vesicle, excoriation/secondary
infection, sometimes forming
burrows.
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Clinical variations : “Incognito” scabies Scabies in infants &
children Noduler scabies Scabies transmitted
by animals Scabies “in a clean” Norwegian scabies
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● Additional examinations :- Microscopic → mites, eggs, faeces- Burrows → tetracycline- Skin biopsy
● Diagnosis :- Itch, especially at night-time (nocturnal itching)- History of infection on members of the family / people living under the same roof- Characteristic distribution of lesion- Characteristic lesion → burrows- Definite diagnosis → mites, eggs, faeces- Tx antiscabies → improvement
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● Treatment :– Gamexan 1%– Crotamiton 10%– Sulfur 5 – 10%– Benzoil benzoate 20 – 35%– Permethrin 5%
● To achieve treatment success : - Treat every contact person - Correct drug administration - Washing clothes and towels with hot water,
air mattress under the sun - Avoid excess treatment
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• P. capitis → P. humanus var capitis• P. corporis → P. humanus var
corporis• P. pubis → Phtirus pubis
Pathogenesis :- Direct contact- Indirect contact
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P. CAPITIS● Clinical manifestation : often affects children● Symptoms :
- itch, especially on the occipital & temporal parts → excoriation,
erosion / secondary infection- swelling of the lymph glands
P. CORPORIS● Clinical features :
- hemorrhagic macules / papules with punctum in the middle- urtica
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P. PUBIS● Mites → pubic hair, eyebrows, eyelashes,
axillae region, sometimes body hair● Clinical features :
- itch → excoriation / secondary infection
- Characteristic → “maculae cerulae”
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Diagnosis :P. capitis : shiny eggs on hair,
mitesP. corporis : eggs / mites on clothes’
foldsP. pubis : eggs / mites on pubic hair,
eyelashes, body hairTreatment :
P. capitis : - gamexan 1% shampoo - permethrin 1% cream - crotamiton 10% cream /
lotionP. corporis : - gamexan 1%
- Washing clothes / bed sheets
using hot water / ironing them
P. pubis : - petrolatum - physostigmine 0,025% eye
oint
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