Diagnosis Demam pada Bayi

Oleh :

dr.Nailla Fariq Alfiani

Tujuan utama diagnosis demam pada bayi usia 0–60 hari adalah untuk melihat adanya infeksi bakteri serius (IBS). Selain pengukuran suhu, penting dilakukan identifikasi red flags seperti mottled appearance, pucat, adanya sianosis, takikardia dan takipnea, capillary refill time (CRT) >3 detik, penurunan urine output (UO), serta adanya penurunan aktivitas bayi.

Penurunan aktivitas pada bayi dapat diidentifikasi dari poor feeding, penurunan respon terhadap stimulus eksternal, tidak tersenyum, letargi, maupun high-pitched cry yang lemah.[1,2]

Adanya red flags ini menunjukkan kemungkinan infeksi bakteri serius (IBS), dimana pada keadaan ini bayi harus dirujuk dari fasilitas kesehatan primer dan mendapatkan pemeriksaan lengkap seperti darah lengkap, urinalisis, serta kultur darah untuk identifikasi penyebab spesifik infeksi.[1,2]

Referensi

1. Pantell RH, Adams WG, Roberts KB, Dreyer BP, Kuppermann N, O’Leary ST, et al. Clinical Practice Guideline: Evaluation and Management of Well-Appearing Febrile Infants 8 to 60 Days Old | Pediatrics | American Academy of Pediatrics. Pediatrics. 2021 Aug;148(2). https://publications.aap.org/pediatrics/article/148/2/e2021052228/179783/Clinical-Practice-Guideline-Evaluation-and?autologincheck=redirected%3fnfToken%3d00000000-0000-0000-0000-000000000000
2. Barbi E, Marzuillo P, Neri E, Naviglio S, Krauss B. Fever in Children: Pearls and Pitfalls. Children. 2017 Sep 1;4(9):81.
3. Balli S, Shumway KR, Sharan S. Physiology, Fever. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2022. http://www.ncbi.nlm.nih.gov/books/NBK562334/
5. Karyanti MR. Fever of Unknown Origin. Sari Pediatri. 2019 Nov 28;21(3):202–6.
6. Baysal B, Baysal BT, Calkavur S, Atlihan F. Etiology of Fever in Neonates: Is It Just Due to Infection? J Pediatr Infect Dis. 2018 Sep;13(3):224–8.
9. Gould J. Fever in the Infant and Toddler: Practice Essentials, Neonates, Young Infants. 2021 Oct 17. https://emedicine.medscape.com/article/1834870-overview#a7
12. Hymczak H, Gołąb A, Mendrala K, Plicner D, Darocha T, Podsiadło P, et al. Core Temperature Measurement—Principles of Correct Measurement, Problems, and Complications. Int J Environ Res Public Health. 2021 Jan;18(20):10606.
17. Hanna CM, Greenes DS. How much tachycardia in infants can be attributed to fever? Ann Emerg Med. 2004 Jun;43(6):699–705.
21. Consolini DM. Fever in Infants and Children - Pediatrics. MSD Manual Professional Edition. 2022. https://www.msdmanuals.com/professional/pediatrics/symptoms-in-infants-and-children/fever-in-infants-and-children
27. Ishimine P. Fever in the Young Infant. In: Rose E, editor. Pediatric Emergencies: A Practical, Clinical Guide. Oxford University Press; 2020. https://doi.org/10.1093/med/9780190073879.003.0009
36. Vega RM, Avva U. Pediatric Dehydration. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2022. http://www.ncbi.nlm.nih.gov/books/NBK436022/
43. Kuppermann N, Dayan PS, Levine DA, Vitale M, Tzimenatos L, Tunik MG, et al. A Clinical Prediction Rule to Identify Febrile Infants 60 Days and Younger at Low Risk for Serious Bacterial Infections. JAMA Pediatr. 2019 Apr 1;173(4):342–51.
44. Green R, Webb D, Jeena PM, Wells M, Butt N, Hangoma JM, et al. Management of acute fever in children: Consensus recommendations for community and primary healthcare providers in sub-Saharan Africa. Afr J Emerg Med. 2021 Jun 1;11(2):283–96.
45. Utama IGDL. The Art Managing Fever, Our Daily Problem. PKB IKA XVIII. Fakultas Kedokteran Universitas Udayana/RSUP Sanglah Bali. 2017. https://simdos.unud.ac.id/uploads/file_penelitian_1_dir/03008727abdef51861521566d6e96f9b.pdf
46. Kasırga E. The importance of stool tests in diagnosis and follow-up of gastrointestinal disorders in children. Turk Arch Pediatr. 2020 Nov 27;54(3):141–8.
47. Soon GS, Laxer RM. Approach to recurrent fever in childhood. Can Fam Physician Med Fam Can. 2017 Oct;63(10):756–62.
48. Ogoina D. Fever, fever patterns and diseases called ‘fever’ – A review. J Infect Public Health. 2011 Aug 1;4(3):108–24.
49. Lubis IND, Lubis CP. Penanganan Demam pada Anak. Sari Pediatri. 2016 Nov 17;12(6):409–18.
50. Yusa T, Tateda K, Ohara A, Miyazaki S. New possible biomarkers for diagnosis of infections and diagnostic distinction between bacterial and viral infections in children. J Infect Chemother. 2017 Feb 1;23(2):96–100.
51. Bhavana M. Fever and Serology. Pediatr Infect Dis. 2020 Aug 14;2(1):29–31.
52. Ismoedijanto I. Demam pada Anak. Sari Pediatri. 2016 Dec 6;2(2):103–8.
53. Maheshwari A. Neutropenia in the Newborn. Curr Opin Hematol. 2014 Jan;21(1):43–9.
54. Queremel Milani DA, Jialal I. Urinalysis. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2022. http://www.ncbi.nlm.nih.gov/books/NBK557685/
55. De Luca A, Zanelli G. Gastroenteritis and Intractable Diarrhea in Newborns. In: Buonocore G, Bracci R, Weindling M, editors. Neonatology: A Practical Approach to Neonatal Diseases. Cham: Springer International Publishing; 2018. p. 1355–63. https://doi.org/10.1007/978-3-319-29489-6_233
56. Wen Q, Liu K, Yue W, Shao S, Zhang S, Li X, et al. Clinical significance of positive fecal occult blood test in neonates. Sci Rep. 2019 Nov 29;9(1):17898.
57. Shlamovitz G. Lumbar Puncture (LP) Interpretation of Cerebrospinal Fluid: Cerebrospinal Fluid Analysis. 2022. https://emedicine.medscape.com/article/2172226-overview
58. Seehusen D, Reeves M, Fomin D. Cerebrospinal fluid analysis. Am Fam Physician. 2003 Oct 1;68:1103–8.
59. Aronson PL, McCulloh RJ, Tieder JS, Nigrovic LE, Leazer RC, Alpern ER, et al. Application of the Rochester Criteria to Identify Febrile Infants with Bacteremia and Meningitis. Pediatr Emerg Care. 2019 Jan;35(1):22–7.
76. Jain, Sanjay N et al. “Decoding the neonatal chest radiograph: An insight into neonatal respiratory distress.” The Indian journal of radiology & imaging vol. 30,4 (2020): 482-492. doi:10.4103/ijri.IJRI_281_20
79. Hamilton JL, Evans SG, Bakshi M. Management of Fever in Infants and Young Children. Am Fam Physician. 2020;101(12):721-729. https://www.aafp.org/pubs/afp/issues/2020/0615/p721.html#definition-of-age-groups-and-fever

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Diagnosis Demam pada Bayi

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