Page 281 - Abstract Book KONIKA 18

Infection & Tropical Disease

P-ITD-51
Disseminated Histoplasmosis in Adolescent with HIV: A Case Report

Benediktus Andries, Ratni Indrawati, Eggi Arguni, Amalia Setyati, 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 Histoplasmosis is a granulomatous disease caused by inhalation of the dysmorphic fungus
Histoplasma capsulatum. Clinical manifestation may range from single organ to life-threatening disseminated
disease. Skin manifestation occurs as a result of hematogenous dissemination in 17.5% of pediatric
histoplasmosis and the mortality may approach 23%. Objective This case warns an immediate recognition
of histoplasmosis to improve the outcome. Case A 15-year-old male HIV teenager, who is non-adherent
to anti-retroviral therapy, had complaints multiple nodules and plaques on his face for 2 months. Four
days prior to admission to our hospital, he developed intermittent fever, cough, and dyspnea with the
progression of the skin lesions over the trunk and extremities. Physical examination showed chest retraction,
splenomegaly, and hepatomegaly. Cutaneous examination found generalized multiple polymorphs, discrete,
keratotic papulonodular, and covered with crust. Histoplasma capsulatum were isolated from skin and blood
samples. Patient then be given itraconazole. Chest X-Ray and CT-Scan were done as the respiratory distress
worsen. Imaging modalities showed miliary lesions. RT-PCR SARS-CoV-2 test revealed negative. He was
then diagnosed as disseminated/miliary histoplasmosis differential diagnosed with miliary tuberculosis.
Unfortunately, he passed away on day 11 of hospitalization despite the treatment with itraconazole, antibiotic,
anti-tuberculosis, and anti-retroviral regiment. Conclusion Miliary histoplasmosis may mimick miliary
tuberculosis. Early recognition of disseminated histoplasmosis and promptly adequate management in HIV
children are needed to improve the outcome.
Keywords: disseminated histoplasmosis; histoplasma; HIV; adolescent

P-ITD-052
A Descriptive Study on COVID-19 on Pediatric Patients in Pademangan District,
North Jakarta: Confirmed Cases and Vaccination Rate

Nadhira Anindita Ralena
Dr. Cipto Mangunkusumo National Central General Hospital, Jakarta, Indonesia
Abstract
Background The clinical impact of the SARS-CoV-2 B.1.617.2 (Delta) variant on children and young people
regarding acute respiratory COVID-19 is not fully defined. Delta variant has been implicated as a more
pathogenic variant. Pademangan Primary Health Care stands in one of the crowded districts in Jakarta. The
abrupt increment of cases on June 2021 in Indonesia generated immense chaos in every level of the health
care system. Meanwhile, at the same time, enhanced vaccination goals with new population target should
be achieved. Objective Describing COVID-19 confirmed cases and vaccination rate on Pediatric Patients in
Pademangan District, North Jakarta. Methods A descriptive study was conducted in Pademangan Primary
Health Care in July 2021. Data of confirmed patients from January-July 2021 ranging from 0 to 17-year-old
were collected. The number of vaccinated children since the first recommendation by Indonesian Pediatric
Society was first released on June 2021, was also gathered. Results Since January 2021, counted there were
802 children and adolescents confirmed with COVID-19 in Pademangan District. By mid-July 2021, 157
confirmed pediatric patients underwent self-isolation requiring supervision in a mutual period. By the end
of July 2021, 8,911 (60% of target) children and adolescents from 12-17 years old have received their first
vaccination dose. Conclusion The rapid increment of cases on June 2021 has caused mayhem of system in
the primary health care, as treatment and prevention aspects should both meet each respective goal. High
enthusiasm for COVID-19 vaccination in Pademangan have assisted the ongoing service to fulfil its target.
Keywords: COVID-19; vaccination; children; adolescents

KONIKA XVIII Abstract Book 233