Page 274 - Abstract Book KONIKA 18

Infection & Tropical Disease

P-ITD-037
Status Epilepticus in Child with COVID-19: A Case Report

1
Randy Renaldo Wiratara , Unyar Leresati , Felix Nathan Trisnadi 1
2
1
Ngesti Waluyo Christian Hospital and Temanggung Public Hospital , Temanggung, East Java, Indonesia
2
Abstract
Background Coronavirus Disease-19 (COVID-19) is challenging health emergency. Despite its pulmonary
and thrombosis manifestations, COVID-19 has neurological manifestations, such as anosmia, ageusia, seizure,
and status epilepticus. Neurologic manifestations are considered as consequences of inflammatory response
related to SARS-CoV-2 infection. Further study is necessary for better diagnosing and treating children with
COVID-19, especially those accompanied by severe neurological manifestation. Objective To report clinical
features, treatment, and outcome of status epilepticus in child with COVID-19. Case A 2-year-old boy
was admitted to emergency room with ongoing seizure. Tonic seizure had been going on since 40 minutes
before admission. He had first day fever, cough, and coryza. First, he was treated with oxygen through nasal
cannula and diazepam suppository. Because his seizure persisted, he was given intravenous diazepam, and
his seizure resolved. From physical examination, we found somnolence consciousness, fever, tachypnea
with minimal chest indrawing, normal oxygen saturation level, no meningeal sign, normal physiological
reflexes, and no pathological reflexes. From laboratory examination, we found relative lymphocytosis,
high CRP level, and positive COVID-19 RT-PCR test. Chest X-ray showed bronchopneumonia. He
was treated with ceftriaxone, dexamethasone, vitamin C, vitamin D, phenobarbital, and paracetamol as
needed. His condition improved. He was discharged at parents’ request after 2 days of hospitalization.
Conclusion We should be aware of possibility that status epilepticus as one of neurological manifestations
of COVID-19 in children. Benzodiazepine is still considered as first line therapy for status epilepticus in
children with COVID-19, despite its respiratory suppression properties.
Keywords: status epilepticus; COVID-19; SARS-CoV-2

P-ITD-038
Retinal Detachment in Ocular Toxoplasmosis Patient

I Made Rian Amerta Dananjaya, I Wayan Gustawan
Department of Child Health, Faculty of Medicine, Universitas Udayana, Sanglah General Hospital,
Denpasar, Bali, Indonesia
Abstract
Background Congenital toxoplasmosis with retinal detactment are two devastating clinical entities and it is
a rare complication in ocular toxoplasmosis. There is little information in literature about the interaction. In
this report, we present a case with ocular toxoplasmosis with retinal detachment. Objective To determine the
natural history of treated congenital toxoplasmosis and to report the clinical course and prognosis of retinal
breaks and detachments occurring in patients with ocular toxoplasmosis. Case A five years old boy, was came
to Sanglah hospital with visual impairment. He was diagnosed with congenital toxoplasmosis. Laboratory
finding in 2017 shown that he has positive IgG anti-toxoplasmosis with consentration around 723. Since 2017,
he get therapy according to congenital toxoplasma protocol therapy. He get pyrimethamine loading dose with
2 mg/kg/day for first 2 days and continue with 1 mg/kg/day. He also get prednisone because there is retinitis
in the examination. We consult to ophthalmologist to evaluate the visual aquity and there is no deterioration
in visual acuity but the swelling are decreasing in OCT examination. After pyrimethamine therapy has done,
we repeated OCT examination and it shown that adnormalities in his retina are said to be permanent and
have caused scarring without any harm. We also repeat examination for the laboratory in 2019, its shown
that IgG anti-toxoplasmosis still positive but decreasing in consentration. We also monitor for side effect
for the therapy with laboratory and there is no side effects yet. Conclusion The functional prognosis for the
patients with retinal detachment was poor. Careful retinal examination in ocular toxoplasmosis is warranted.
Keywords: toxoplasmosis; retinal detachment

226 KONIKA XVIII Abstract Book