Hi pak Amin,
Saya coba share dari beberapa info yang sempat saya baca dan pahami ya, pak :)
(BTW, sorry kalau ‘out of date’ karena kalau lihat tanggal e-mailnya pak Amin itu 2
hari yang lalu??). Moga-moga anaknya malah sudah sembuh ya, pak...
SCABIES
Disebabkan parasit yang hanya menginfeksi manusia. Bermula dari telur di dalam kulit
lalu menetas jadi tungau dewasa. Ditularkan dari kontak dengan penderita scabies atau
binatang anjing. Butuh waktu mingguan hingga akhirnya tubuh anak bereaksi, yaitu
dengan menggaruk bagian tubuh yang gatal. (selain di area seputar kelamin, bisa juga
di antara jari-jari tangan/kaki, bagian dalam pergelangan tangan, ketiak), bentuknya
bisa seperti bruntusan atau lepuhan. Umumnya jika 1 anggota keluarga terinfeksi,
family lain juga terinfeksi dan harus diperiksa juga.
Diagnosa sederhana untuk Scabies, biasanya dokter/dokter kulit mengoleskan minyak
mineral ke area tubuh yang diduga mengandung tungau/telur, lalu hasil ulas (scrap)
diperiksa dengan mikroskop untuk identifikasi parasit. Diagnosa untuk Scabies jika
dokter menemukan tungau/telur dalam hasil ulas tsb. Anak pak Amin menjalani test ini
juga, nggak?
Obat yang digunakan umumnya lotion mengandung permethrin (Elimite) yang bisa membunuh
tungau. Kadang diresepkan juga antihistamin dan cream steroid (jika perlu). Obat
Scabicide umumnya sangat efektif membunuh tungau dengan cepat, walau anak bisa tetap
mengalami gatal-gatal beberapa minggu setelah itu sejalan dengan tubuhnya yang mulai
sembuh dari reaksi alergi tsb. Treatment untuk anak kecil setelah 1x24 jam bisa
membuat anak tsb. ‘bebas’ dari status ‘menularkan penyakit’ nya.
Kalau saya baca jenis obat/salepnya, kelihatannya memang cenderung ‘resepnya diulang
lagi’ untuk periode tertentu, mungkin daya tahan tungau/telur nya cukup ‘bandel’, jadi
perlu waktu yang ‘agak’ lama untuk membunuhnya.
Nah, mungkin salep Scabimite yang dipakai anak pak Amin termasuk golongan
Scabicide(cmiiw), hanya dipakai 1x (karena setelah itu anak tidak menginfeksi orang
lain lagi), juga setelah pengobatan anak memang masih ‘suka garuk-garuk juga’, saya
kutip statement aslinya, ya..
“...The scabicide medicine is usually very effective and kills the mites quickly, but
your child may continue to have the itchy rash for several weeks as his body heals
from the allergic reaction...” (sorry... saya nggak sempat copy-paste sumber asli
link-nya).
Targetnya untuk ‘get rid of Scabies’ itu: menghilangkan tungaunya, so selain treatment
medis, dibantu juga dengan sering mencuci pakaian juga seprei dan sarung
bantal/selimut, karpet anak & family.
KENCING BATU
Nah, ini yang saya bingung juga, kenapa dokter langsung ‘pindah diagnosa’ jadi kencing
batu? Jarang terjadi, tapi anak kecil bisa juga menderita kencing manis, dengan
gejala-gejala seperti: sakit pinggang, darah atau nanah dalam urine, muntah, sakit
punggung, sakit saat BAK, infeksi saluran kemih (ISK) yang berulang. Kadang anak juga
tidak mengalami keluhan apa-apa. Memang untuk mendeteksi penyakit ini salah satunya
dengan USG. Cuma saya tidak dapati bahwa ‘menggaruk-garuk area kelamin’ itu termasuk
gejala ‘kencing batu’. Mungkin pak Amin perlu konsul dengan ahli kulit anak karena
mereka lebih ahli dalam menangani dermatologi anak (kalau memang Scabies diagnosanya),
karena mungkin juga gatal-gatal tsb. sama sekali bukan Scabies.
Ini saya kutipkan FAQ tentang kencing batu pada anak.
Maaf kalau tidak banyak membantu ya, pak.. and take a good care for anaknya,
Sylvia – Jovan’s mum
Sumber: www.pediatriconcall.com
Q: What are urinary stones? I thought stones were seen in adults. Does it occur in
children?
A: Stones are formed when substances such as calcium, phosphate, uric acid, oxalate
are in excess in urine, become insoluble and form concretions and settle on a matrix
in tubules. Urinary infections can increase the size of these concretions and further
harden them. Although stones are common in adults, they can occur in children.
Q: How do these urinary stones occur?
A: Stones occur due to abnormal and excessive accumulation of stone forming substances
in urine which are normally dissolved due to presence of substances which inhibit
stones formation like citrate, pyrophosphates. If the concentration of calcium,
oxalate, uric acid, cystine etc is very high and inhibitors are low, stone formation
occurs. The abnormal metabolic disorders can be inherited e.g. Hypercalciuria,
hyperoxaluria, cystinuria. Less intake of fluids, urinary infection, congenital
anomalies of urinary tract with obstruction, hyperparathyroidism, RTA (renal tubular
acidosis) are causes of renal calculi or stones.
Q: How do I know whether my child is suffering from kidney stones?
A: Kidney stones can give rise to abdominal pain, hematuria (blood in urine),
vomiting, backache, recurrent urinary tract infections or are accidentally discovered
on USG (Ultrasonography).
Q: How does one diagnose presence of renal stones?
A: Diagnosis is made by plain X-ray of kidneys, ureters and urinary bladder or
ultrasonography.
Q: My child’s X-rays showed no stones. However, the doctor says that he is suffering
from kidney stones. Is it possible?
A: Some kidney stones are radiolucent i.e. cannot be seen on plain x-rays but can be
diagnosed by Ultrasonography e.g. uric acid, cystine stones.
Q: Is USG a must to do in a patients with kidney stones?
A: If a high degree of suspicion exists and plain X-rays do not show stones, USG is a
must for diagnosis. Small stones pass out with high fluid intake, citrate treatment,
alkali administration etc.
Q: My child has a renal stone, However he has no complaints. Does he still have to get
treated? Can’t we just leave him alone?
A : If the kidney stone (s) is small and is causing ho complaints there is no need to
treat. Periodic imaging(USG) is required to assess the size and whether it has moved
from its location. However, a larger stone requires treatment as it may later cause
complications like colic, renal damage etc.
Q: Most of the members of our family had stones some point in life. Is there something
like a family history of stones? How is stone formation prevented?
A: Family history of renal stones helps in early diagnosis of certain metabolic
disorders which are precursors for stone formation e.g. hypercalciuria which can be
detected by 24 hours urine excretion of calcium. More than 4mg/kg/day calcium
excretion is abnormal. Advise regarding high fluid intake helps in prevention.
Certain areas are known for increased prevalence for renal calcium or urolithiasis
because of hot climate, excess of calcium/ manganese/ aluminium and many other
minerals in soil/ water which increase the solute load. People living in these areas
including children suffer from increased incidence of stones. In India, Rajasthan,
Kutch and certain areas of Gujarat, Punjab are known as stone belts.
Q: My child had sudden onset of pain, which he felt from the loin to his penis. What
to do?
A: When pain starts suddenly from loin to penis, it means that the stone has moved and
is trying to come out. At this time pain reliever and antispasmodic medication is
advised namely Ibuprofen and Dicyclomine. Fresh Ultrasonography/ X-rays are needed to
localize the stone. Child may require hospitalization if pain is severe till the stone
is passed. IV fluids, IV NaHCO3 with furosemide can push the stone out.
Q: In a child with calcium stones, should milk be omitted from the diet?
A: In growing children, restriction of milk or dairy product to reduce calcium in diet
is not advisable because calcium and high class milk proteins are required for growth
and mineralisation of bones. Tonics containing excess of calcium should be avoided.
Q: How is a child with renal stones to be monitored?
A: Child with renal stones should be monitored regularly for symptoms like pain,
hematuria, urinary complaints like dysuria (pain while passing urine), frequency,
burning etc. Ultrasonography should be done every 2-3 months to look at the progress
of stone. Urine is examined for hematuria (blood in urine), pyuria (pus in urine) and
if required urine culture for UTI should be done till the stone is passed or removed.
Q: What is the prognosis of a child with renal stones?
A: Prognosis is good if the stone is single and isolated. But recurrent stones, which
obstruct the urinary passage and are associated with recurrent calculi and recurrent
UTI can progress to CRF.
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Amin Ch <[EMAIL PROTECTED]> wrote:
1. Ciri2 anak yang mengalami penyakit kencing batu itu seperti apa ? Apa
mungkin anak kecil bisa mengalami penyakit itu?
2. Ciri2 penyakit scabies seperti ? Berapa lama pengobatannya?
3. Selain scabies, apa yang bisa menyebabkan gatal bekerpanjangan di sekitar
alat kelamin anak ?
<deleted>
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