Page 404 - Abstract Book KONIKA 18

Respirology

P-RES-028
Urinary Incontinence as Long-Term Complication of Pott’s Disease:
A Case Report

Ernie Yantho, Riza Sahyuni, Moh Syarofil Anam, Muhammad Heru Muryawan,
Dwi Wastoro Dadiyanto, Magdalena Sidhartani
Department of Child Health, Faculty of Medicine, Universitas Diponegoro/Dr. Kariadi General Hospital,
Semarang, Central Java, Indonesia
Abstract
Background Prevalence of pediatric tuberculosis (TB) has been increasing worldwide, especially in TB
endemic countries including Indonesia. Children are at higher risk of extrapulmonary TB, contributing to
morbidity and long-term sequelae. Spinal TB or Pott’s disease, occurs mostly in children and young adults.
Objective To describe the clinical course and complication of spinal tuberculosis. Case A sixteen years old girl
referred to our hospital with history of prolonged fever and seizure with loss of consciousness. On admission,
she was diagnosed with meningoencephalitis TB from brain imaging which showed hydrocephalus and basal
enhancement. Xpert MTB/RIF showed Mycobacterium tuberculosis detected low. First line antituberculosis
drug with fixed drug combination (Rifampicin, Isoniazid, Pyrazinamide, and Ethambutol) and steroid was
given. On follow up, after two months of intensive phase regimen, clinical symptoms were improved but
paraparesis and urinary incontinence persisted. Magnetic resonance imaging of thoracolumbar spine showed
tuberculoma at corpus vertebrae level T1, myelitis involving corpus vertebrae T6-T9 and arachnoiditis
involving corpus vertebrae T3-T7 which suggested of spinal TB. Post micturition abdominal ultrasound
showed features of neurogenic bladder. After a year of antituberculosis treatment, she still had complaint of
urinary incontinence without any signs of improvement. Medical therapy has been given to treat neurogenic
bladder affected by spinal TB. Conclusion Our case emphasizes that patient with meningoencephalitis TB
complicated with spinal TB had urinary incontinence despite adequate antituberculosis treatment.
Keywords: spinal tuberculosis; Pott’s disease; urinary incontinence

P-RES-029
Biphasic Stridor in Infant: What to Suspect and To Do?

Rifan Fauzie, Dimas Dwi Saputro, Retno Widyaningsih
Pediatric Respirology,Harapan Kita National Women and Children Hospital, Jakarta, Indonesia
Abstract
Background Biphasic stridor in infant is caused by various etiologies. Clinically, most of them are
vigorously life-threatening and potentially worsening. Flexible bronchoscopy has a pivotal role to identify
the diagnosis. The early recognition and appropriate management will lead us to satisfactory results.
Objective To exhibit the important role of flexible bronchoscopy role in management of infant with biphasic stridor.
Cases Case 1 A-8-month-old boy, with acute biphasic stridor in a week. He had a choking episode during
the mealtime. From flexible bronchoscopy revealed a fish bone stuck in the middle of vocal cord and
successfully retrieved. Case 2 A-5-month-old baby girl suffered from biphasic stridor since 4-week-old.
Heavy chest retraction and difficulty in breathing. Flexible bronchoscopy performed and found a subglottic
mass (subglottic hemangioma). She was treated with oral propranolol for 8 month and the stridor vanished.
Case 3 A-4-month-old baby girls suffered from biphasic stridor since 2-week-old. Clinical appearance was
like case 2. A subglottic hemangioma found from flexible bronchoscopy. She also given oral propranolol,
during 4th month of treatment, the stridor significantly diminished. Conclusion Flexible bronchoscopy
procedure is a must performed procedure to determine the cause of biphasic stridor in infant.

Keywords: biphasic stridor; infant; flexible bronchoscopy; foreign body aspiration; subglottic
hemangioma

356 KONIKA XVIII Abstract Book