Page 276 - Abstract Book KONIKA 18

Infection & Tropical Disease

P-ITD-041
An Obese Child with Warning Signs of Dengue: A Case Report

Rini Wulandari, Ninny Meutia Pelupessy, Husein Albar, Ratna Dewi Artati
Department of Child Health, Faculty of Medicine, Universitas Hasanuddin/Dr. Wahidin Sudirohusodo General
Hospital, Makassar, South Sulawesi, Indonesia
Abstract
Background Dengue has emerged as a global public health problem. About 500,000 affected patients of
50–100 million cases will develop severe dengue infection. Obesity may play a role in the deterioration
of dengue infection, so the treatment should be given promptly. Objective To show the management of
dengue with warning signs in obese children. Case A boy aged 15 years was admitted to our hospital with
a chief complaint of fever since five days before admission followed by headache and retroorbital pain. On
his physical examination, there was hypertension grade I and hyperthermia. We also found petechiae on
the extremities and ascites in the abdomen. The patient’s anthropometric status was obese with BMI of 43.
There were leukopenia, thrombocytopenia, hemoconcentration about 58%, and positive dengue IgG and
IgM serology. MSCT without contrast showed bilateral pleural effusion. In this patient, there were clinical
fluid accumulation and increase in hematocrite concurrent with rapid decrease in platelet count, so we
categorized him as dengue with warning signs. This patient has hypertension due to the risk of systemic
complication in obese children. We treated this patient as group B dengue with warning signs where
the fluid replacement therapy based on ideal body weight and also gave ace inhibitor for hypertension.
On the 4th day of hospitalization, there was an improvement condition and the ascites was reduced.
Conclusion Dengue patient with comorbidities such as obesity may develop severe dengue. Proper
management will minimize the occurrence of severe dengue.
Keywords: dengue; obese; hypertension

P-ITD-042
Antibiotic Patterns and Sensitivity in PICU Patients
in Dr. M. Djamil Hospital Padang: A Restropective Study

Shinta Asbi, Rinang Mariko
Department of Child Health, Faculty of Medicine, Universitas Andalas/Dr. M. Djamil Hospital,
Padang, West Sumatera, Indoneia
Abstract
Background Almost all pediatric patients treated in Pediatric Intensive Care Units (PICU) receive
antibiotic. The empirical use of antibiotics, is closely related to the incidence of antibiotic resistance. It
is necessary to have a description of pattern of bacteria as a basis for preventing antibiotic resistance.
Objective To describe the antibiotic pattern and sensitivity in PICU at DR M Djamil hospital. Methods This
research was conducted using a descriptive-retrospective design. Data obtained from Microbiology Laboratory
of Dr. M. Djamil Padang Hospital and medical records of PICU patients. Bacterial culture and sensitivity
test from January 2020-December 2020 were collected. Results A total of 79 samples were obtained. Most
common gram-negative bacteria found were Klebsiella pneumonia and Pseudomonas aeruginosa (16.8%).
Most gram-positive bacteria found was Staphylococcus haemolyticus (5.3%). Most sensitive antibiotic for
gram-negative bacteria was amikacin (18.3%) and for gram-positive was vancomycin and Cloramphenicol
antibiotics (18.5%). Most resistant antibiotic to Gram-negative bacteria was gentamicin (12.2%), for most
resistant gram-positive bacteria was erythromycin (26.7%). Conclusion+ The most sensitive antibiotic for
Gram-negative was amikacin and for gram-positive were vancomycin and chloramphenicol. Most resistant
antibiotic to Gram-negative bacteria was gentamicin and for Gram-positive bacteria was erythromycin.
Keywords: bacteria culture; bacteria pattern; antibiotic resistance; PICU

228 KONIKA XVIII Abstract Book