Page 399 - Abstract Book KONIKA 18

Respirology

P-RES-018
Tuberculosis Manifesting as Mediastinal Mass in an Obese Teenager:
A Case Report

Rahmawaty Rahimi, Fahreza A. Neldy, Madeleine Ramdhani Jasin, Darmawan Budi Setyanto
Department of Child Health, Respirology Division, Cipto Mangunkusumo Hospital, Faculty of Medicine Universitas
Indonesia, Jakarta, Indonesia

Abstract
Background Tuberculosis (TB) rarely presents with involvement of mediastinum. This type of disease
is usually seen in conjunction with primary pulmonary TB. However primary TB in this area without
involvement of the lung is scarce and often mistaken for malignancies. Objective To demonstrate a rare
case of mediastinal TB. Case A 15-year-old obese -adolescent girl had history of recurrent chest pain since 2
years prior to admission. She complained of cough for 2 weeks. Plain chest x-ray showed thickening of right
superior mediastinum and lobulated right hilar suggesting multiple lymphadenopathy. She was diagnosed with
thymoma. Thorax CT-scans confirmed multiple lymphadenopathy in mediastinum, supraclavicular region and
left inferior of clavicula , also calcification in third segment of the right lung. TB was evaluated as tuberculin
test resulting in 22 mm induration. Bacteriology for TB was negative. She then underwent thoracotomy and
histopathology resulted in hassal corpuscle, multinodular tubercle with epithelioid multinucleated chronic
giant cell with caseous necrosis. Summarized as chronic granulomatous due to Mycobacterium tuberculosis
infection and healthy thymus tissue. Patient subsequently was treated with four-TB-drugs and dietary
intervention for obesity. TB involving mediastinum is considered severe debilitating disease. Although rare
, TB involving the mediastinum may also present with non-specific general symptoms. The diagnosis could
be difficult, majorly due to invasive specimen collection required for histopathological and bacteriological
confirmation. Conclusion Tuberculosis should be considered as differential diagnosis of mediastinal masses,
though it is unusual. Early diagnosis and prompt treatment will improve outcome.
Keywords: tuberculosis; mediastinal mass; adolescent; obesity

P-RES-019
Sensitivity and Specificity of Rapid Antibody Diagnostic Test
for Diagnosing COVID 19 in Pediatric Patients
Rifah Zafarani Soumena, Kadek Dhanya Chandita, Retno Asih Setyoningrum
Department of Child Health, Faculty of Medicine Universitas Airlangga/Dr. Soetomo General Academic Hospital,
Surabaya, East Java, Indonesia
Abstract
Background Corona Virus Disease 2019 (COVID-19) pandemic has infected over 37 million people globally,
causing over 1 million deaths. The diagnosis of COVID 19 relies on the detection of SARS-CoV-2 nucleic
acid; however, routine diagnosis by SARS-CoV PCR swab examination is limited for most laboratories and
takes long time to get results. Objective To compare sensitivity and specificity of alternative rapid antibody
diagnostic test for COVID-19 compared to SARS-CoV PCR. Methods Aim of this observational analysis
design is to analyse a rapid antibody diagnostic test for screening COVID-19 pediatric patients from March
2020 to March 2021. The analysis is using the gold standard SARS-CoV2 PCR. Diagnostic parameters
were analysed using a 2x2 table. Results The sample of this study consisted of 207 patient who underwent
a SARS-CoV2 PCR swab examination, which consisting of 70 subject with positive result and 137 subject
with negative results. The patient with positive result which consisting of 48 subject with reactive in rapid
antibody diagnostic test COVID 19 and 22 subject with non-reactive rapid antibody diagnostic test COVID
19. The sensitivity of the test was 68.57% (95%CI 56.37 to 79.15%). Specificity was 48.9% (95%CI 40.28 to
57.58%). There was substantial agreement between SARS-CoV2 PCR results and a rapid antibody diagnostic
test COVID 19. Conclusion The current evaluation of antibody-based system shows low sensitivity and
low specificity result.
Keywords: COVID-19; SARS-CoV2 infection; SARS-CoV-2 testing; COVID-19 antibody testing;
COVID-19 serological testing

KONIKA XVIII Abstract Book 351