Page 402 - Abstract Book KONIKA 18

Respirology

P-RES-024
Clinical Characteristic and Diagnosis Challenge of Abdominal Tuberculosis
in Children: Tertiary Hospital's Profile in The Last Five Years

Wan Rita Mardhiya, Diah Asri Wulandari, Cissy B. Kartasasmita, Heda Melinda Nataprawira
Department of Child Health, Hasan Sadikin General Hospital/Faculty of Medicine, Universitas Padjadjaran,
Bandung, West Java, Indonesia

Abstract
Introduction Abdominal tuberculosis (ATB) is a rare manifestation of childhood tuberculosis (TB).
Diagnosis of ATB is often misdiagnosed and delayed due to non-specific symptoms and limited diagnostic
tests. Objective To provide and overview clinical manifestations, laboratory and radiology findings of ATB
cases. Methods This retrospective study was conducted by collecting medical records of children who were
diagnosed with ATB. We identified the cases using the International Classification of Disease (ICD 10th
Revision). We collected data from June 2016–June 2021 in Hasan Sadikin General Hospital. Gender, age,
clinical manifestations, laboratory, and radiology findings were recorded. Results There were 35 patients
with ATB, 20 were females (57%), and mean age was 14 years. More than half of the patients (57%) were
undernourished. Household contact discovered in 23% of cases; 83% of cases received BCG vaccination;
and history of previous TB treatment in 34% of cases. The most common manifestation was abdominal
pain (83%), weight loss (85%), anorexia (71%), and malaise (71%). Only 33% patients showed positive for
tuberculin skin test. Mycobacterium tuberculosis culture was positive in 3% cases. Acid-fast bacilli smear
from sputum/gastric aspirate was positive in 6%; Xpert MTB/Rif in stool was positive in 39% cases. Chest
x-ray showed pleural involvement in 29% of cases. The abnormal imaging by computed tomography or
ultrasound included lymphadenopathy (48%) and ascites (36%). Conclusion Abdominal pain, weight loss,
anorexia, and malaise are the common symptoms in ATB. As Xpert MTB/Rif yielded more than one-third
ATB, we suggest to do that examination in patients suspected with ATB.
Keywords: abdominal tuberculosis; children

P-RES-025
Round Pneumonia, A Pitfall Diagnosis

Suhasta Nova, Retno Asih Setyoningrum
Department of Child Health, Faculty of Medicine Universitas Airlangga/Dr. Soetomo General Academic Hospital,
Surabaya, East Java, Indonesia

Abstract
Background Round pneumonia is pneumonia with pulmonary round lesion that clinical manifestation is not
specific, so it often causes misdiagnosis. Round pneumonia is a rare case. Objective To report the case atypical
pneumonia, focusing on diagnosis. Case Eight years old boy, 21 kg, was brought to the emergency department
of Dr. Soetomo Hospital Surabaya with chief complain of fever for 13 days before admission. Patient also
complain dry cough 11 days before with low intensity, chest pain that localized with general condition was
quite good. Patients already had treatment before admission, but the complaints did not improve. The signs
from physical examination were found fever with body temperature 39.1oC and tachycardia with heart rate
126bpm, and respiratory rate 22tpm. Chest X-ray revealed spherical mass-like-opacity that is conclude as
round pneumonia. He was diagnosed as round pneumonia. Three days after treat with clarithromycin, the
clinical manifestation was improved. Seventh days after treat with clarithromycin, clinical manifestation
and chest X-ray was improved.Conclusion Round pneumonia is an atypical pneumonia that can causes
misdiagnosis with other disease because of the clinical manifestation is not specific and it is a rare case.

Keywords: round pneumonia; atypical pneumonia

354 KONIKA XVIII Abstract Book