Page 280 - Abstract Book KONIKA 18

Infection & Tropical Disease

P-ITD-049
The First Case of Multisystem Inflammatory Syndrome in Children
in Dr. Soetomo Hospital: A Case Report

Yunita Puspitasari, Dominicus Husada, Leny Kartina, Zahrah Hikmah, Dwiyanti Puspitasari,
Mahrus A Rahman, Parwati Setiono Basuki, Ismoedijanto
Department of Child Health, Dr. Soetomo General Academic Hospital, Faculty of Medicine Universitas Airlangga,
Surabaya, East Java, Indonesia
Abstract
Background Manifestations of COVID-19 in children include hyperinflammatory syndrome and multiorgan
involvement, and called as multisystem inflammatory syndrome in children (MIS-C). Objective To report
first case of MIS-C at Dr. Soetomo Hospital. Case A previously healthy 2.5 years old boy came to hospital
with the history of six days persistent fever, erythematous rash, and hyperemic eyes. Many people in his
neighborhood suffered from Covid-19. He was born spontaneously and breastfed for two years. Physical
examination revealed lymph node enlargement, cracked, inflamed, and dry lips, but no strawberry tongue
or stomatitis. Laboratory examination showed ESR 102/hour, white blood cell 19.630/mm , CRP 45 mg/L,
3
and D-Dimer 8677.93 ng/ml. The neutrophil lymphocyte ratio was 5.06. Blood culture was sterile along
with normal chest x-ray. Echocardiography showed dilatations of LMCA (3.0-3.3 mm) and RCA (2.5 mm)
diameters. The patient had positive SARS CoV-2 immunoglobulin test, and was diagnosed as MIS-C. The
management was aimed at restoring organ function, reducing systemic inflammation, risk of death, and long-
term sequel. Intravenous immunoglobulin (2g/kgBW/single dose) and high oral dose of aspirin (100mg/
kgBW/day divided into four doses) were started. After three days, the patient improved clinically. Aspirin
(5mg/kgBW/dose) was continued for 8 weeks, and subsequently, echocardiography evaluation revealed
improvement of LMCA (0.25 cm) but not the RCA. The six months echocardiography evaluation was normal.
Conclusion MIS-C is one manifestation of Covid-19 in children. The diagnosis and clinical management
are somewhat similar to Kawasaki Disease.
Keywords: multisystem inflammatory syndrome in children; Kawasaki-like disease COVID-19;
dilatation of arteries; first case; Dr. Soetomo Hospital Surabaya

P-ITD-050
Clinical Profiles of Children with Covid-19 in Dr. R. Soedarsono General
Hospital, Pasuruan City

1
Peter Prayogo Hsieh , Hans Kristian , Pramita Anindya , Pherenice Charisti , Wienta Diarsvitri 2
1
1
1
Faculty of Medicine, Universitas Hang Tuah, Surabaya and Department of Child Health, Dr. R. Soedarsono Hospital,
1
Pasuruan , East Java, Indonesia
2
Abstract
Background Fewer cases of Covid – 19 have been diagnosed in children than in adults. Clinical profiles
of pediatric Covid-19 in Indonesia are still rarely reported. Objective To report clinical profiles in
pediatric Covid-19 cases in Dr. R. Soedarsono General Hospital Pasuruan City from April - July 2020.
Methods This descriptive study was done in pediatric department using medical records of all patients aged
0 – <18-year-old with suspicious symptomps of Covid-19. Diagnosis was made by pediatricians. Samples
were then being categorized as suspected infection, probable infection, confirmed infection, or close contact
to infected person using Covid-19 standard diagnosis criterias from Indonesia Health Minister 2020 3rd
edition guideline. Results 78 subjects, 41 (53%) were male and 42 (54%) were hospitalized due to their
symptoms. Infants and teenagers dominated the cases, 18 subjects (23%) respectively. Thirty two (41%) of
subjects had moderate symptoms. From all children, we found that 31 (39%) of them had a history of close
contact to infected person. The most common symptoms were cough (59%) and fever (54%) while the most
common laboratory abnormality was leukocytosis (58%). Sixty three percents of subjects showed normal
radiologic findings. There were only 10% of subjects who had comorbidities. The outcomes were satisfying,
99% of subjects were discharged in good conditions. Conclusions Most of pediatric Covid-19 patients in
Dr. R. Soedarsono General Hospital had moderate symptoms with good outcomes.
Keywords: clinical profiles; children; Covid-19

232 KONIKA XVIII Abstract Book