Page 391 - Abstract Book KONIKA 18

Respirology

P-RES-003
Congenital Cystic Adenomatoid Malformation in Infant:
A Case Report from Rural Area

Chindy Arya Sari, Rienaldi, Irlisnia, Susan Hendriarini Mety
Dr. (H.C.) Ir. Soekarno Hospital, Kepulauan Bangka Belitung, Indonesia

Abstract
Background Congenital cystic adenomatoid malformation (CCAM) is a rare pulmonary disorder with
an incidence of 1 per 25,000 live births. CCAM is characterized by the formation of cysts in certain
locations of the lungs. Respiratory distress is the most common symptom found in CCAM. The diagnosis
of CCAM is challenging, often misdiagnosed as pneumothorax, emphysema or diaphragmatic hernia.
Objective To improve knowledge about this condition, the difficulty of diagnosis and management,
especially in areas with limited resources. Case presentation A 29-day-old male infant was referred to our
hospital due to a complaint of shortness of breath since 4 days old. The patient was previously diagnosed
with diaphragmatic hernia. Physical examination showed suprasternal retraction, soft crackles in both lung
fields, and heart sounds heard in the right hemithorax. Chest radiography showed a septate cystic cavity
in the left hemithorax, pushing the heart laterally to the right, and left lung herniation. Thoracic CT-scan
results were suggestive of bronchopulmonary dysplasia (BPD) of the left, with right lung pneumonia.
A surgical consultation was obtained, and the patient was subsequently diagnosed with CCAM. The patient
underwent upper left lobectomy thoracotomy surgery performed by a thoracic surgeon brought in from
Jakarta. Pathological examination confirmed the diagnosis of CCAM. Conclusion The diagnosis of CCAM
is challenging due to its rarity and requires specialized diagnostic modalities which are unavailable in most
healthcare facilities. A comprehensive, multidisciplinary approach is essential for the management of CCAM.
Keywords: CCAM; infant; respiratory distress

P-RES-004
Clinical Abdominal Tuberculosis Coinfection with COVID-19 in Children

Denalia Aurika , Kirana Kamima 2
1
1
General Practitioner and Departement of Child Health, Budhi Asih Regional Hospital, Jakarta, Indonesia
2
Abstract
Background Abdominal tuberculosis is a rare form of extrapulmonary tuberculosis in children. The signs
and symptoms are usually nonspecific, so it is often confused with other diseases. After 1.5 years, COVID-19
pandemic continues to affect many children in Indonesia. There were some studies that reported coinfection
between pulmonary tuberculosis and COVID-19. However, extrapulmonary tuberculosis and COVID-19 in
children are still underreported. Objective To describe clinical features and favorable therapy in coinfection
between COVID-19 and abdominal tuberculosis in children Case A 7-year-old girl, weighing 16 kg, came to
our ER with a difficulty to defecate for a week. The night before she came, she couldn’t pass any flatus. She
was vomiting and couldn’t take any meal. She had a history of fever and cough for a month. From physical
examination, her stomach was distended and the intestine peristaltic was decreasing. PCR for SARS-CoV-2
test was positive. Abdominal x-ray was obtained and revealed sign of obstruction. In the inpatient ward,
she tested positive for Mantoux test. Antivirus, antibiotic, antituberculosis, and steroid were given to treat
her condition. With these treatments, her stomach circumference has decreased since the first day she was
admitted. After three weeks of admission, her clinical status was getting better and she was discharged from
our hospital. Conclusion Tuberculosis screening in COVID-19 pandemic situation still needs to be done
thoroughly. Abdominal tuberculosis in children is rarely found because the symptoms are usually nonspecific.
With a strong clinical suspicion, treatment of abdominal tuberculosis with COVID-19 coinfection can show
good improvement.
Keywords: COVID-19; abdominal tuberculosis; children

KONIKA XVIII Abstract Book 343