Page 126 - Abstract Book KONIKA 18

Cardiology

P-CAR-019
Kawasaki Disease Manifestation in Covid-19: A Case Report

Jeffri Simatupang, Elviri Ngedihu, Ivan Riyanto Widjaja, Susanto Isman
Koja General Hospital, Jakarta, Indonesia
Abstract
Background Covid-19 has been declared as a global pandemic by the WHO on March 2020. Covid-19
has affected only 2% in younger than 20 years. During pandemic, vasculitis known as Kawasaki Disease
(KD) in Covid-19 is rare. KD is an acute disease, where predominantly affects children under the age of 5,
more common in boys, and leads to coronary aneurysm in 25% untreated cases. Objective To evaluate the
manifestation of Kawasaki Disease with Positive Covid-19. Case A nine-year-old boy is brought to Koja
General Hospital with a ten-day low-grade intermittent fever associated with cough. He was hospitalized in
other hospital with typhoid fever and treated with antibiotics. He discharged against medical advice on fifth
day due to unbreaking fever. Physical examination showed normal nutrition status, bilateral conjunctivitis with
dry, cracked lips, strawberry tongue and redness in both limbs. Cervical lymph node enlargement was found.
Laboratory findings showed elevated CRP, anemia, thrombocytosis and hypoalbuminemia. No abnormal
findings in Echocardiography. Typical KD was diagnosed, nasopharyngeal swab was done, and Single
Dose IVIG 2 g/kg was planned. Aspirin was given 50 mg/kg/day for three days continued with 3mg/kg/day.
Nasopharyngeal swab gave positive result with D-dimer 1690 ng/mL and normal Troponin-T yield working
diagnosis of Kawa-Covid though thrombocytosis was found. After 24 hours of IVIG treatment, the fever
started to break and the patient discharged after ten days of hospitalization. Conclusion KD should always be
differentially diagnosed with Kawa-Covid though both treated with same dose of IVIG. Use of thrombocyte
count to differentiate both diseases seem unreliable.
Keywords: Covid-19; Kawasaki Disease; IVIG; Kawa-Covid

P-CAR-020
Infective Endocarditive in Single Atrium Single Ventricle
with Irreversible Pulmonary Hypertension

Diah Ayu Pitaloka, Mahrus A. Rahman, Teddy Ontoseno, Alit Utamayasa, Taufiq Hidayat
Department of Child Health, Faculty of Medicine Universitas Airlangga/Dr. Soetomo General Academic Hospital,
Surabaya, East Java, Indonesia
Abstract
Background Infective endocarditis in children remains an important and complex clinical problem with
significant mortality risk varying from 5 to 10%. Congenital heart disease is one of the predispositions which
increased the risk. Univentricular heart is rare and accounts for 1-2% of all congenital cardiac malformations.
We did not find any reports from Indonesia in long survival of such patients. Objective To present a case
of single atrium, single ventricle survived from infective endocarditis. Case A 12-year-old girl came to
Dr. Soetomo Hospital's outpatient clinic, Surabaya, with fever for two weeks. The patient got a fever two
days after the dental braces procedure. Echocardiographic revealed endocarditis. Patient was diagnosed with
single atrium and single ventricle since birth. In this case, there was no stenosis on pulmonary valve, the
blood from the heart burst in to the lung, resulting having pulmonary hypertension. The patient admitted to
hospital and received antibiotics for 42 days. Conclusion It is important for early diagnosis and therapy of
rare heart disease with serious infective complication.

Keywords: infective endocarditive; single atrium; single ventricle; univentricular, pulmonary
hypertension; kongenital heart disease

78 KONIKA XVIII Abstract Book