Page 255 - Abstract Book KONIKA 18

Infection & Tropical Disease

P-ITD-004
Erythema Multiforme Major Mimicking MIS-C: A Case Report

Benediktus Andries, Eggi Arguni, Cahya Dewi Satria, Ida Safitri Laksono
Department of Child Health, Faculty of Medicine, Public Health, and Nursing Universitas Gadjah Mada/
Dr. Sardjito General Hospital, Yogyakarta, Central Java, Indonesia
Abstract
Background Erythema multiforme (EM) is a self-limiting, immune-mediated mucocutaneous condition
commonly associated with certain infections and medication. In pediatric population, 20% of patients
present with EM major, which has mucous membrane involvement. In COVID-19 pandemic, such of
the skin manifestations may overlapped with multisystem inflammatory syndrome in children (MIS-C).
Objective To provide the discussion of EM major which demonstrates favourable self-limiting course of
disease and its manifestations resembling MIS-C. Case A 4-year-old boy from an area with high transmission
of COVID-19 presented with fever, erythematous macular cutaneous lesions, and mouth sores. The lesions
spread progressively throughout the body and symmetrically on extremities, palms and soles with the
involvement oral and occular mucous membranes 5 days prior to presentation. Physical examination only
showed non-purulent conjungtivitis and oral ulcer. He underwent investigations for suspicion of MIS-C
and Kawasaki disease. Inflammation markers were risen, but RT-PCR and antibody SARS-CoV-2 revealed
negative. Serology IgG/IgM anti HSV-1 and HSV-2 were negative. Echocardiography showed no abnormality.
The patient was diagnosed with EM major. He was treated with supportive management of paracetamol and
topical moisturizer. None of steroid or other medication were given. The patient was discharged after clinical
and laboratory improvement on the 7th day of hospitalization. Conclusion Careful examination should be
done to exclude severe diagnosis such as MIS-C and Kawasaki disease. Erythema multiforme may resolve
spontaneously and further studies are needed to address the benefit of steroids in treating major cases.
Keywords: erythema multiforme; steroid; multisystem inflammatory syndrome in children

P-ITD-005
Parosmia, A Post Covid Syndrome in Adolescent : A Case Report

Fitri Nur Dini , Ayu Novianti 2
1
Permata Husada Hospital, Banjarbaru, South Borneo and Amalia Hospital, Bontang, East Borneo , Indonesia
2
1
Abstract
Background Parosmia is a disorder which the patient smells an undue odor. Parosmia is also reported to
be a symptom of post-covid 19. Although this symptom is typical in adults, it can also occur in children
and adolescent. Objective To present a case-finding regarding one of the effects of Covid-19 in children
and adolescent. Case A 17-year-old girl came to the clinic with the chief complaint of a foul-smelling nose
since one month ago. Every time the patient smelled something, the smell would remain rotten and there
would be no other smell. Three months earlier, the patient was diagnosed Covid-19. The patient felt that
the sense of smell suddenly disappeared without any complaints of a cold. Two months later, the patient
went to the polyclinic because the complaint did not reduce. The patient received corticosteroid nasal spray
and multivitamin. The patient was scheduled for follow-up one month later. At the subsequent follow-up,
a foul-smelling smell appeared. All results of the examination were normal. The patient is taught how to
clean their noses and practice smelling every day. The exercise was carried out with strong odor stimuli and
observed every month. Conclusion Parosmia is one of the post-covid syndromes that can last a long period.
This complaint takes a long time in healing and has an unclear prognosis to return to normal. In children
and adolescent, this complaint greatly interferes with the child's appetite and confidence. So, it requires help
from the parent to control and encourage their child.

Keywords: child; adolescent; smell; olfaction disorder; Covid-19

KONIKA XVIII Abstract Book 207