ASPEK LABORATORIUM KLINIK FILARIASIS<br />Tinjauan Pustaka Mikrobiologi<br />Hermi Indita / Prihatini<br />1<br />
2<br />
3<br />
Patogenesis<br />Siklus Hidup<br />4<br />
Gambar 2. Siklus hidup Filaria 6<br />5<br />
Patogenesis lanjutan..<br /><ul><li>Cacing dewasa & mikrofilaria yang hidup pada getah bening	      reaksi hipersensitif  ...
Infeksi berulang 	  obstruksi getah bening menetap		edema, fibrosis & obstruksi 	elefantiasis	 </li></ul>6<br />
Patogenesis lanjutan...<br /><ul><li>Dari hasil ultrasound didapatkan dilatasi limfatik bukan hanya  karena cacing yang ma...
Terjadi infeksi sekunder akibat jamur & bakteri
Didalam tubuh cacing dewasa W.bancrofti terdapat bakteri simbion genus Wolbachia.
Wolbachia mempunyai efek antihelmintik & molekul mirip endotoksin yg berperan pada respon inflamasi pada cacing mati </li>...
Gejala Klinis<br />8<br />
9<br />
Gambar 4. Penderita  positif W.bancrofti dengan filarial abscess scar. 8<br />Gambar 3. Penderita positif W bancrofti deng...
Diagnosis <br />11<br />
Pemeriksaan konsentrasi <br />Hasil <br />12<br />
Metode konsentrasi Knott<br />13<br />
Sediaan darah tebal segar<br />Sediaan darah tebal kering<br />14<br />
Sediaan darah tipis<br />15<br />
Tehnik Filtrasi Membran<br />16<br />
Tehnik QBC (Quantitative Buffy Coat Technique)<br />17<br />
18<br />
19<br />
TERIMA KASIH<br />20<br />
Blood Smear - Microfilaria <br /><ul><li>Note wavy microfilarial worm in the thick part of blood film.
Clumps of RBC (normal in thick part of film).
Platelet clumps around the worm.</li></li></ul><li>Blood Smear - Microfilaria <br /><ul><li>Note wavy microfilarial worm i...
Clumps of RBC (normal in thick part of film).
Platelet clumps</li></li></ul><li>Blood Smear - Microfilaria <br /><ul><li>Note wavy microfilarial worm in the thick part ...
Head part
Tail (dark blue structures are nuclei)</li></li></ul><li>Blood Smear - Microfilaria <br /><ul><li>Note wavy microfilarial ...
Dark blue structures are nuclei
Tail end tapering (no nuclei)
Sheath covering worm.</li></li></ul><li>Blood Smear - Microfilaria <br /><ul><li>Note wavy microfilarial worm in the thick...
Head end of the worm – rounded (no nuclei)
(Sheath is not clearly seen)</li></li></ul><li>Blood Smear - Microfilaria <br /><ul><li>Note wavy microfilarial worm in th...
Dark blue structures are nuclei
Tail end - tapering sheath (no nuclei)</li></li></ul><li>Case 2 - Hydrocele fluid:<br />Specimen sent from primary health ...
Hydrocele fluid – cell block. <br /><ul><li>Note wavy microfilarial worms.
Inflammatory cells – lymphocytes.
Hemorrhagic fluid sediment</li></li></ul><li>Hydrocele fluid – cell block. <br /><ul><li>Note wavy microfilarial worms.
Inflammatory cells – lymphocytes.
RBC</li></li></ul><li>Hydrocele fluid – cell block. <br /><ul><li>Note wavy microfilarial worms.
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  1. 1. ASPEK LABORATORIUM KLINIK FILARIASIS<br />Tinjauan Pustaka Mikrobiologi<br />Hermi Indita / Prihatini<br />1<br />
  2. 2. 2<br />
  3. 3. 3<br />
  4. 4. Patogenesis<br />Siklus Hidup<br />4<br />
  5. 5. Gambar 2. Siklus hidup Filaria 6<br />5<br />
  6. 6. Patogenesis lanjutan..<br /><ul><li>Cacing dewasa & mikrofilaria yang hidup pada getah bening reaksi hipersensitif tipe cepat : infiltrasi limfosit, sel plasma, eosinofil </li></ul> hiperplasi endotel dinding saluran getah bening, gejala limfangitis akut dan trombosis<br /><ul><li>Cacing yang mati reaksi imunologi hebat terbentuk jaringan granuloma
  7. 7. Infeksi berulang obstruksi getah bening menetap edema, fibrosis & obstruksi elefantiasis </li></ul>6<br />
  8. 8. Patogenesis lanjutan...<br /><ul><li>Dari hasil ultrasound didapatkan dilatasi limfatik bukan hanya karena cacing yang mati dan mengkalsifikasi tetapi juga oleh bagian cacing tersisa yang hidup & bergerak
  9. 9. Terjadi infeksi sekunder akibat jamur & bakteri
  10. 10. Didalam tubuh cacing dewasa W.bancrofti terdapat bakteri simbion genus Wolbachia.
  11. 11. Wolbachia mempunyai efek antihelmintik & molekul mirip endotoksin yg berperan pada respon inflamasi pada cacing mati </li></ul>7<br />
  12. 12. Gejala Klinis<br />8<br />
  13. 13. 9<br />
  14. 14. Gambar 4. Penderita positif W.bancrofti dengan filarial abscess scar. 8<br />Gambar 3. Penderita positif W bancrofti dengan hidrokel bilateral, pembesaran testikular dan lymphadenopathy inguinal. 8<br />Gambar 5 A. Penderita elefantiasis bilateral 10<br />Gambar 5 B. Penderita elefantiasis dekstra 10<br />10<br />
  15. 15. Diagnosis <br />11<br />
  16. 16. Pemeriksaan konsentrasi <br />Hasil <br />12<br />
  17. 17. Metode konsentrasi Knott<br />13<br />
  18. 18. Sediaan darah tebal segar<br />Sediaan darah tebal kering<br />14<br />
  19. 19. Sediaan darah tipis<br />15<br />
  20. 20. Tehnik Filtrasi Membran<br />16<br />
  21. 21. Tehnik QBC (Quantitative Buffy Coat Technique)<br />17<br />
  22. 22. 18<br />
  23. 23. 19<br />
  24. 24. TERIMA KASIH<br />20<br />
  25. 25. Blood Smear - Microfilaria <br /><ul><li>Note wavy microfilarial worm in the thick part of blood film.
  26. 26. Clumps of RBC (normal in thick part of film).
  27. 27. Platelet clumps around the worm.</li></li></ul><li>Blood Smear - Microfilaria <br /><ul><li>Note wavy microfilarial worm in the thick part of blood film.
  28. 28. Clumps of RBC (normal in thick part of film).
  29. 29. Platelet clumps</li></li></ul><li>Blood Smear - Microfilaria <br /><ul><li>Note wavy microfilarial worm in the thick part of blood film.
  30. 30. Head part
  31. 31. Tail (dark blue structures are nuclei)</li></li></ul><li>Blood Smear - Microfilaria <br /><ul><li>Note wavy microfilarial worm in the thick part of blood film.
  32. 32. Dark blue structures are nuclei
  33. 33. Tail end tapering (no nuclei)
  34. 34. Sheath covering worm.</li></li></ul><li>Blood Smear - Microfilaria <br /><ul><li>Note wavy microfilarial worm in the thick part of blood film.
  35. 35. Head end of the worm – rounded (no nuclei)
  36. 36. (Sheath is not clearly seen)</li></li></ul><li>Blood Smear - Microfilaria <br /><ul><li>Note wavy microfilarial worm in the thick part of blood film.
  37. 37. Dark blue structures are nuclei
  38. 38. Tail end - tapering sheath (no nuclei)</li></li></ul><li>Case 2 - Hydrocele fluid:<br />Specimen sent from primary health center<br />Hydrocele fluid for examination.<br />Cell block preparation from the fluid stained with routine H&E Stain.<br />27<br />
  39. 39. Hydrocele fluid – cell block. <br /><ul><li>Note wavy microfilarial worms.
  40. 40. Inflammatory cells – lymphocytes.
  41. 41. Hemorrhagic fluid sediment</li></li></ul><li>Hydrocele fluid – cell block. <br /><ul><li>Note wavy microfilarial worms.
  42. 42. Inflammatory cells – lymphocytes.
  43. 43. RBC</li></li></ul><li>Hydrocele fluid – cell block. <br /><ul><li>Note wavy microfilarial worms.
  44. 44. Inflammatory cells – lymphocytes.
  45. 45. RBC</li></li></ul><li>Hydrocele fluid – cell block. <br /><ul><li>Inflammatory cells – lymphocytes.
  46. 46. RBC
  47. 47. Microfilaria. </li></li></ul><li>Discussion: Filariasis<br />infestation by nematodes – widely distributed. <br />Adult worms both male and female, several cm long, reside in subcutaneous tissue, lymph & blood vessels. <br />Motile embryos - microfilariae circulate in blood or on skin. <br />Microfilariae are not infectious to humans but to arthropod (mosquito)<br />32<br />
  48. 48. Discussion: Filariasis<br />Filaria infesting humans:<br />Wuchereria bancrofti – Elephantiasis<br />Brugia malayi – milder form, lymphatics.<br />Onchocerca volvulus – Eye, blindness, Africa<br />Loa Loa – Loaisis, Africa, repeated swellings.<br />Mansonella perstans – Africa, asymptomatic.<br />33<br />
  49. 49. Diperiksadi bawah lensaobyektifkhusus (paralens) berkekuatan 60X ygdihubungkan fiber optik<br />Sampel darah dimasukkankedalam tabungkapilermengandung AO & anti koagulan<br />Tabungkapilerdisentrifuse<br />Cara Pemeriksaan<br />34<br />
  50. 50. 35<br />
  51. 51. Morphology of the microfilaria (mf)<br />36<br />
  52. 52. 37<br />
  53. 53. 38<br />
  54. 54. 39<br />
  55. 55. 40<br />
  56. 56. 41<br />
  57. 57. 42<br />
  58. 58. 43<br />

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