Infeksi Saluran Kemih Kompleks pada Bayi Perempuan 10 Bulan dengan Hidronefrosis dan Hidroureter Dupleks
Laporan Kasus
DOI:
https://doi.org/10.31004/anthor.v5i4.1044Keywords:
Infeksi Saluran Kemih Kompleks, Bayi, Hidronefrosis, Hidroureter, Neurogenic Bladder, Meropenem, Urologi PediatrikAbstract
Infeksi saluran kemih (ISK) merupakan salah satu infeksi bakteri tersering pada anak. Bila disertai kelainan anatomi atau fungsional saluran kemih, ISK dapat berkembang menjadi bentuk kompleks (cUTI) yang berisiko menimbulkan jaringan parut ginjal dan penyakit ginjal kronis. Seorang bayi perempuan usia 10 bulan datang dengan demam berulang tanpa gejala respirasi atau gastrointestinal. Riwayat retensi urin ditemukan saat rawat inap sebelumnya. Pemeriksaan fisik menunjukkan sakit sedang dengan takikardi. Urinalisis memperlihatkan leukosituria, hematuria, proteinuria, dan bakteriuria; prokalsitonin meningkat. CT-scan abdomen dengan kontras menunjukkan hidronefrosis, hidroureter dupleks, dan dilatasi kandung kemih, mengarah pada obstruksi outlet kandung kemih atau kandung kemih neurogenik. Pasien mendapat terapi intravena berupa meropenem, amikasin, dan metronidazol sesuai pedoman Infectious Diseases Society of America (IDSA) 2025 dan European Society of Pediatric Infectious Diseases (ESPID). Perbaikan klinis dicapai selama perawatan. Kasus ini menekankan pentingnya deteksi dini, evaluasi pencitraan komprehensif, dan tata laksana multidisiplin pada ISK kompleks anak. Kepatuhan terhadap pedoman terkini sangat penting untuk mencegah komplikasi jangka panjang.
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