Page 263 - Abstract Book KONIKA 18

Infection & Tropical Disease

P-ITD-017
To Highlight Therapy Abdominal Tuberculosis in Children Using 4 Regiment
Antituberculosis Drug: A Case Report

Steffany Maria Lainama, Karolina Trigemayanti Tallo
Department of Child Health, SK Lerik Hospital, Kupang, East Nusa Tenggara, Indonesia

Abstract
Background Abdominal Tubercolsis (Abdominal TB) is one of the common site of extrapulmonary
tuberculosis which is affect mostly young adult but uncommon in children. Symptoms are generally not
specific, such as abdominal pain, low grade fever, and chronic weight loss. 4 regiment anti tuberculosis
drug (Rifampicin, Pyrazinamide, Isoniazid and Ethambutol) are used as a therapy for Abdominal TB.
Objective To demonstrate favorable outcome of abdominal tb in children using 4 regiment antituberculosis
drug. Case A nine years old girl came to emergency department with complaint of weakness and severe
abdominal pain since 1 week before admission. Abdominal pain was felt continuosly in all region of abdomen.
Patient also complained nausea and vomiting with every meal. The patient could still be flatus and defecate.
Parents also complained of fever since 1 month of admission, continously and tend to be in the afternoon,
and also decrease of appetiate and weight loss in the past month. History of chronic cough for 2 months,
sometimes with phlegm, without blood. TB contact history 6 years ago. On examination, we found, the child
look malnourished and anemia. No bowel sound was heard, accompanied by tenderness in all quadrant of
abdomen and defence. In imaging we found pulmonary tuberculosis. TB scoring was 8 (without mantoux
test). The patient was diagnosed with Abdominal TB, Pulmonary TB, Anemia, and marasmus type of
malnutrition. The child was given antibiotic injection, adult anti-TB category I (RHZE), and management
of malnutrition. The child then went home after 2 weeks of treatment with the condition of gaining weight,
improving abdominal pain and intake. Anti-TB drug was continued. Conclusion Abdominal TB is rarely
found in children. Many complaints are abdominal pain, low grade fever, and chronic weight loss leading to
malnutrition. It can be accompanied by pulmonary TB. Using 4 regiment antituberculosis drug can help to
treat this disease without surgery. TB scoring could used to help diagnosis tuberculosis without BTA sputum
test, so we can treat the patient as soon as possible.
Keywords: abdominal tuberculosis; children; antituberculosis drug

P-ITD-018
Multisystem Inflammatory Syndrome in Children with Neurological,
Gastrointestinal, Hematological, and Cardiovascular Manifestations:
A Case Report

Fenny D’silva, Nina Dwi Putri, Amanda Soebadi, Tartila, Anisa Rahmadhany
Department of Child Health, Faculty of Medicine, Universitas Indonesia/ Dr. Cipto Mangunkusumo General Hospital,
Jakarta, Indonesia

Abstract
Backgroud Multisystem inflammatory syndrome in children (MIS-C) is a rare but serious condition
associated with COVID-19. Symptoms of MIS-C reflect the various organ systems affected.
Objective To increase awareness on the clinical manifestations of MIS-C as a newly recognized disease
entity in general pediatrics. Case A 4-month-old girl with no significant past medical history presented with
generalized tonic clonic seizures, fever, diarrhea, and circulatory shock. Initial laboratory results demonstrated
leukocytosis, acute kidney injury, coagulopathy, elevated inflammatory markers, and elevated troponin I.
SARS-CoV-2 IgM and IgG were reactive, SARS-CoV-2 antigen was negative and SARS-CoV-2 PCR was
negative. Echocardiography was normal heart and cerebrospinal fluid analysis was normal. The patient met
clinical criteria for MIS-C and was treated with intravenous immune globulin (IVIG) plus glucocorticoid for
ten days. She was discharged with resolution of her clinical symptoms. Conclusion Multisystem inflammatory
syndrome in children (MIS-C) can present with a board range of clinical symptoms. Early recognition of
the MIS-C associated with SARS-CoV-2 is critical because it causes serious and life-threatening illness in
previously healthy children.
Keywords: COVID-19; SARS-CoV-2; multisystem inflammatory syndrome in children

KONIKA XVIII Abstract Book 215