Pustaka Ilmiah Universitas Padjadjaran

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Karakteristik Dengue Berat yang Dirawat di Pediatric Intensive Care Unit

Virus dengue dapat menyebabkan infeksi pada semua kelompok usia dengan manifestasi klinis beragam mulai dari asimtomatik, ringan, sampai berat yang biasanya merupakan kasus fatal. Dengue berat ditandai dengan kebocoran plasma, hemokonsentrasi, dan gangguan hemostasis. Penelitian ini bertujuan untuk mengetahui karakteristik penderita dengue berat yang dirawat di ruang Pediatric Intensive Care Unit (PICU) RS Dr. Hasan Sadikin Bandung sejak Januari 2009 sampai Desember 2010. Penelitian dilakukan secara retrospektif deskriptif berdasarkan data dari rekam medis penderita. Sebanyak 21 penderita dengue berat dirawat selama 2 tahun, 15/21 penderita perempuan dan 6/21 laki-laki, serta 5/21 anak meninggal dunia selama dirawat dengan sebab kematian tersering sindrom syok dengue (SSD) dan kogagulopati intravaskular diseminata (KID). Sebagian besar penderita berusia 1-5 tahun dengan status gizi baik. Hepatomegali ditemukan pada semua penderita dengan hematokrit rata-rata 38%. Pada penelitian ini, manifestasi klinis dengue berat berupa SSD (15/21), KID (11/21), ensefalopati (6/21), efusi pleura (5/21), miokarditis (3/21), serta acute respiratory distress syndrome (3/21). Simpulan, dengue berat lebih banyak didapatkan pada anak perempuan, usia 1–5 tahun, serta status gizi baik. Manifestasi klinis dengue berat yang dominan berupa syok, koagulasi intravaskular diseminata, dan ensefalopati.

Dengue viral infections affect all age groups and produce a spectrum of clinical illness that ranges from asymptomatic to severe and occasionally fatal disease. Severe dengue characterized by plasma leakage, hemoconcentration, and hemostatic disorder. The aim of this study was to know the characteristic of severe dengue patients admitted to Pediatric Intensive Care Unit (PICU) Dr. Hasan Sadikin Hospital Bandung during January 2009 to December 2010. This was a retrospective descriptive study based on the data collected from the medical records. Twenty-one severe dengue cases in two years were admitted 15/21 girls and 6/21 boys, and 5/21 of them died during hospitalization because of dengue shock syndrome (DSS) and disseminated intravascular coagulation (DIC). Most of them were 1-5 years old with good nutritional status. Hepatomegaly was found in all cases with mean hematocrit was 38%. In this research, the most manifestation of severe dengue were DSS (15/21), DIC (11/21), encephalopathy (6/21), pleural effusion (5/21), myocarditis (3/21), and acute respiratory distress syndrome (3/21). In conclusions, severe dengue are more common in girls, 1–5 years old, and well-nourished children. The most common clinical manifestation of severe dengue are shock, disseminated intravascular coagulation, and encephalopathy.