{"success":true,"data":[{"id":"UROSEPSIS-ESBL-001","title":"Urosepsis ESBL K. pneumoniae — geriatri, eGFR 28","organism":"Klebsiella pneumoniae (ESBL)","difficulty":"intermediate","patient_summary":"Laki-laki 67 th, DM & BPH, eGFR 28. Datang dengan urosepsis (sepsis sumber saluran kemih)."},{"id":"CRBSI-CRE-002","title":"CRBSI CRE — fenotip sama, terapi beda per kelas karbapenemase","organism":"Klebsiella pneumoniae (CRE)","difficulty":"advanced","patient_summary":"Wanita 58 th imunokompromais (keganasan hematologi, kemoterapi), CVC terpasang 12 hari, sepsis."},{"id":"VAP-CRAB-003","title":"VAP CRAB — kombinasi, hindari carbapenem, keterbatasan opsi (RSDM)","organism":"Acinetobacter baumannii (CRAB)","difficulty":"advanced","patient_summary":"Laki-laki 61 th di ICU, ventilator hari ke-9, demam & perburukan (dugaan VAP)."},{"id":"KOLONISASI-INFEKSI-004","title":"Kolonisasi vs Infeksi — kapan TIDAK memberi antibiotik","organism":"Multi-skenario (E. coli / CoNS / P. aeruginosa)","difficulty":"advanced","patient_summary":"Tiga skenario singkat pasien rawat inap dengan hasil kultur \"positif\" pada situasi klinis berbeda."},{"id":"MRSA-BAKTEREMIA-005","title":"Bakteremia MRSA — AUC/MIC, bukan trough; kenali MIC creep","organism":"Staphylococcus aureus (MRSA)","difficulty":"advanced","patient_summary":"Laki-laki 54 th, hemodialisis rutin via kateter tunel, demam & menggigil 2 hari."},{"id":"DTR-PSEUDOMONAS-006","title":"DTR Pseudomonas — mekanisme menentukan obat; hindari kombinasi buta","organism":"Pseudomonas aeruginosa (DTR)","difficulty":"advanced","patient_summary":"Laki-laki 48 th, luka bakar luas (30% TBSA) hari ke-12, demam tinggi & hipotensi ringan."},{"id":"AMPC-INDUKSIBEL-007","title":"AmpC induksibel — jebakan 'seftriakson S' & resistansi on-treatment","organism":"Enterobacter cloacae (inducible AmpC)","difficulty":"advanced","patient_summary":"Laki-laki 59 th, pasca-kolesistektomi hari ke-5, demam & nyeri kuadran kanan atas, kultur darah positif."},{"id":"MSSA-BAKTEREMIA-008","title":"Bakteremia MSSA — de-eskalasi wajib; β-laktam > vankomisin","organism":"Staphylococcus aureus (MSSA)","difficulty":"advanced","patient_summary":"Laki-laki 52 th, DM tipe 2, selulitis tungkai + demam menggigil, kultur darah positif."},{"id":"STENOTROPHOMONAS-009","title":"S. maltophilia — carbapenem justru salah; kenali kolonisasi vs infeksi","organism":"Stenotrophomonas maltophilia","difficulty":"advanced","patient_summary":"Wanita 63 th, keganasan hematologi & neutropenia, ICU/ventilator hari ke-10, riwayat meropenem 8 hari."},{"id":"VRE-BAKTEREMIA-010","title":"Bakteremia enterokokus/VRE — spesies menentukan; daptomycin dosis tinggi","organism":"Enterococcus faecium (VRE)","difficulty":"advanced","patient_summary":"Laki-laki 66 th, pasca-transplantasi ginjal (imunosupresi), rawat lama dengan kateter vena sentral, demam & menggigil."},{"id":"CANDIDEMIA-011","title":"Candidemia — ekinokandin lini-1 (bukan flukonazol) + cabut kateter & funduskopi","organism":"Candida albicans (candidemia)","difficulty":"advanced","patient_summary":"Laki-laki 58 th, pasca-laparotomi di ICU, nutrisi parenteral via kateter vena sentral, demam menetap tanpa fokus bakteri jelas."},{"id":"CRE-NDM-012","title":"CRE NDM/metallo — kelas enzim menentukan; CAZ-AVI gagal sendirian","organism":"Klebsiella pneumoniae (CRE, NDM/MBL)","difficulty":"advanced","patient_summary":"Laki-laki 55 th, baru pulang dirawat di RS luar negeri (Asia Selatan) 3 minggu lalu, kini sepsis sumber saluran kemih/abdomen."},{"id":"CDIFFICILE-013","title":"Infeksi C. difficile — STOP antibiotik pemicu; fidaxomicin/vanko ORAL, bukan metronidazol","organism":"Clostridioides difficile","difficulty":"intermediate","patient_summary":"Wanita 70 th, baru selesai 10 hari antibiotik untuk pneumonia, kini diare cair berulang dengan kram perut."},{"id":"ISK-ESBL-014","title":"ISK ESBL — situs menentukan; sistitis carbapenem-sparing (nitrofurantoin/TMP-SMX)","organism":"Escherichia coli (ESBL)","difficulty":"intermediate","patient_summary":"Wanita 34 th, tidak hamil, disuria dengan frekuensi & urgensi 2 hari, tanpa demam atau nyeri pinggang."},{"id":"MENINGITIS-015","title":"Meningitis bakterial — deksametason SEBELUM antibiotik; empiris per usia/risiko","organism":"Streptococcus pneumoniae (meningitis)","difficulty":"advanced","patient_summary":"Laki-laki 68 th, diabetes, demam dengan kaku kuduk & penurunan kesadaran akut, fotofobia."},{"id":"DRTB-016","title":"TB Resisten-Rifampisin/MDR — rejimen BPaLM, bukan monoterapi; jangan tambah 1 obat","organism":"Mycobacterium tuberculosis (RR/MDR)","difficulty":"advanced","patient_summary":"Laki-laki 41 th, batuk kronik dengan penurunan berat badan & keringat malam, riwayat pengobatan TB tak tuntas."},{"id":"NECFASC-GAS-017","title":"Necrotizing fasciitis (GAS) — bedah dulu; klindamisin anti-toksin; IVIG pada STSS","organism":"Streptococcus pyogenes (GAS, necrotizing fasciitis)","difficulty":"advanced","patient_summary":"Laki-laki 47 th, nyeri tungkai hebat tak proporsional dengan tampakan kulit, demam tinggi & syok, eritema meluas cepat."},{"id":"MELIOIDOSIS-018","title":"Melioidosis — dua fase (intensif IV → eradikasi TMP-SMX); jangan hentikan dini","organism":"Burkholderia pseudomallei (melioidosis)","difficulty":"advanced","patient_summary":"Laki-laki 52 th, petani, diabetes, demam tinggi dengan pneumonia & abses hati, tinggal di area endemik tropis."},{"id":"PJI-OSTEO-019","title":"Infeksi sendi prostetik — source control bedah + rifampin anti-biofilm (jangan monoterapi)","organism":"Staphylococcus aureus (PJI)","difficulty":"advanced","patient_summary":"Laki-laki 67 th, 3 minggu pasca-artroplasti lutut, kini nyeri & bengkak lutut dengan demam & luka operasi mengeluarkan cairan."},{"id":"CANDIDA-AURIS-020","title":"Candida auris — ekinokandin lini-1 + infection control; jangan obati kolonisasi","organism":"Candida auris (kandidemia MDR)","difficulty":"advanced","patient_summary":"Wanita 64 th, rawat ICU lama dengan kateter & ventilator, pindahan dari fasilitas dengan wabah C. auris."},{"id":"MALARIA-UNCOMP-021","title":"Malaria tanpa komplikasi — DHP + primakuin (spesies menentukan); evaluasi kuantitatif parasit cegah rekurensi","organism":"Plasmodium falciparum (tanpa komplikasi)","difficulty":"intermediate","patient_summary":"Laki-laki 28 th, pulang dari area endemik (Papua), demam menggigil periodik 4 hari."},{"id":"MALARIA-BERAT-022","title":"Malaria berat — artesunat IV lini-1 + skill peracikan (rekonstitusi 2-langkah); switch ACT; cegah rekrudesensi","organism":"Plasmodium falciparum (berat)","difficulty":"advanced","patient_summary":"Perempuan 34 th, dari area endemik, demam 5 hari dengan perburukan klinis."},{"id":"MALARIA-HAMIL-023","title":"Malaria pada kehamilan — regimen per trimester; kontraindikasi primakuin/doksisiklin; berat = artesunat IV semua trimester","organism":"Plasmodium falciparum (kehamilan)","difficulty":"advanced","patient_summary":"Perempuan 26 th, hamil 22 minggu, dari area endemik, demam menggigil 3 hari."},{"id":"MALARIA-PROFILAKSIS-024","title":"Profilaksis malaria (ABCD) — pelancong domestik ke Papua; SBET vs kemoprofilaksis; obat & kelompok khusus","organism":"Profilaksis (P. falciparum + vivax)","difficulty":"intermediate","patient_summary":"Laki-laki 30 th sehat, dari Jawa, akan bertugas 6 minggu ke area endemik (Papua). Konsultasi pra-perjalanan."},{"id":"LEPTO-RINGAN-025","title":"Leptospirosis anikterik (ringan) — IgM negatif dini & doksisiklin oral","organism":"Leptospira sp. (anikterik/ringan)","difficulty":"intermediate","patient_summary":"Laki-laki 34 th, demam mendadak 4 hari, mialgia berat, riwayat aktivitas di area banjir."},{"id":"LEPTO-WEIL-026","title":"Penyakit Weil (leptospirosis berat) — ikterik, AKI dengan dialisis, SPHS","organism":"Leptospira sp. (Weil/berat)","difficulty":"advanced","patient_summary":"Laki-laki 41 th, demam 6 hari, kini kuning, urin berkurang, dan gusi berdarah."},{"id":"LEPTO-PARU-027","title":"Leptospirosis paru berat (SPHS anikterik) — gagal napas & serologi negatif dini","organism":"Leptospira sp. (paru berat/SPHS)","difficulty":"advanced","patient_summary":"Laki-laki 29 th, demam 5 hari, sesak memberat dan batuk berdarah."},{"id":"TETANUS-GENERALISATA-028","title":"Tetanus Generalisata (Ablett III → disautonomia): 8 pilar tatalaksana terpadu","organism":"Clostridium tetani","difficulty":"advanced","patient_summary":"Laki-laki 42 th, petani, dengan kekakuan rahang dan kejang otot menyeluruh 3 hari setelah luka tusuk paku berkarat. Kesadaran penuh."},{"id":"TIFOID-RINGAN-029","title":"Demam tifoid tanpa komplikasi — skrining Nelwan, kultur vs Widal, stewardship WHO","organism":"Salmonella Typhi","difficulty":"intermediate","patient_summary":"Laki-laki 24 th, demam >1 minggu pola sore-malam + gejala GI, bradikardia relatif & lidah tifoid. Rawat jalan."},{"id":"TIFOID-TOKSIK-030","title":"Tifoid toksik (ensefalopati) — singkirkan meningitis, seftriakson + deksametason terindikasi","organism":"Salmonella Typhi","difficulty":"advanced","patient_summary":"Perempuan 30 th, demam 12 hari kini penurunan kesadaran/delirium tanpa rangsang meningeal. Tifoid toksik."},{"id":"TIFOID-GIT-031","title":"Komplikasi GIT tifoid — perdarahan vs perforasi, resusitasi, eskalasi & timing bedah","organism":"Salmonella Typhi","difficulty":"advanced","patient_summary":"Laki-laki 28 th, tifoid minggu-3 dengan melena + nyeri perut hebat, defans & bising usus menurun. Syok awal."},{"id":"HIV-ART-032","title":"Koinfeksi TB-HIV (CD4 sangat rendah) — OAT dulu, ARV dalam 2 minggu, TLD double-dose DTG","organism":"HIV + M. tuberculosis","difficulty":"advanced","patient_summary":"Laki-laki 34 th, HIV baru + TB paru (CD4 38). Kapan mulai OAT & ARV, penyesuaian rifampisin."},{"id":"HIV-CNS-033","title":"Toksoplasmosis serebral pada AIDS — imaging dulu, terapi (2 regimen sah), ARV setelah 2 minggu","organism":"Toxoplasma gondii (pada HIV)","difficulty":"advanced","patient_summary":"Perempuan 29 th, AIDS (CD4 62) putus ARV, nyeri kepala + hemiparesis + kejang fokal. Lesi otak."},{"id":"HIV-RESP-034","title":"PCP pada AIDS — kenali vs TB, kotrimoksazol dosis terapi + kortikosteroid bila hipoksemia","organism":"Pneumocystis jirovecii (pada HIV)","difficulty":"advanced","patient_summary":"Laki-laki 41 th, HIV baru (CD4 45), sesak progresif + batuk kering + desaturasi saat aktivitas."},{"id":"FN-HIGHRISK-035","title":"Demam neutropenia risiko tinggi (MASCC <21) — empiris antipseudomonal ≤1 jam, vankomisin bukan rutin","organism":"Neutropenia (LMA pasca-kemoterapi)","difficulty":"advanced","patient_summary":"Laki-laki 52 th, LMA pasca-induksi, ANC 120, demam. MASCC <21 (risiko tinggi)."},{"id":"FN-PERSISTEN-036","title":"Demam neutropenia persisten (4–5 hari) — evaluasi IFI & antijamur empiris (ekinokandin default)","organism":"Neutropenia + dugaan infeksi jamur invasif","difficulty":"advanced","patient_summary":"Perempuan 48 th, LMA, demam menetap 4-5 hari meski beta-laktam luas, ANC masih profound."},{"id":"FN-LOWRISK-037","title":"Demam neutropenia risiko rendah — low-risk MASCC/CISNE, tapi resistensi FQ lokal menggeser keputusan","organism":"Neutropenia (tumor padat pasca-kemoterapi)","difficulty":"advanced","patient_summary":"Perempuan 41 th, tumor padat, demam. MASCC >=21 & CISNE 0, tapi resistensi FQ lokal tinggi."}]}