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All Journal Jurnal Kesehatan Andalas Pediatric Sciences Journal
Viorika, Erli Meichory
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Health Professions Public Health

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A Case of Tuberculous Spondylitis in Child with Undernourish Viorika, Erli Meichory; Yani, Finny Fitry; Sahputra, Roni Eka
Jurnal Kesehatan Andalas Vol. 10 No. 1 (2021): Online March 2021
Publisher : Faculty of Medicine, Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/jka.v10i1.1709

Abstract

Tuberculous spondylitis accounts for around 2% of all cases of Tuberculosis (TB) and around 15% of extrapulmonary TB cases. It has been reported that a 17 years old boy with a complaint of a bump on the lumbar region and felt low back pain since two years before admission with a history of back trauma. There was a decrease of body weight. There was no paraesthesia nor paralysis. Defecation and micturition were normal. Basic immunization was incomplete. On physical examination found palpable lymph nodes 0,5x0,5x0,5 cm, multiple et regio colli. There was no BCG scar. Impression nutritional status was undernourished. There was fixed palpable mass at back size about 5x4x5 cm, hard, no fluctuations, no rebound tenderness. Lung examination was normal. Tuberculin test showed induration sized 20 mm. Gene Xpert result Micobacterium Tuberculosis (MTB) not detected. On chest X-ray examination found L1-2 corpus destruction. MRI Spine was suggestive of compressive fractures and suggestive of a bilateral psoas abscess. Decompression and lumbar stabilization surgery were performed. The histopathology examination results were consistent to spondylitis TB characteristics. The patient was discharged on 6th hospitalization and given anti-tuberculous drug.Keywords:  bump, extrapulmonary, fracture, spondylitis, tuberculosis
Dengue Shock Syndrome (DSS) complicated by severe hyponatremia and seizure in a pediatric patient: a rare case report Fitria, Triola; Viorika, Erli Meichory
Pediatric Sciences Journal Vol. 6 No. 2 (2025): In Press Online : December 2025
Publisher : Medical Faculty of Brawijaya University, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/pedscij.v6i2.138

Abstract

Background: Dengue Shock Syndrome (DSS) represents the most severe form of dengue virus infection, driven by massive plasma leakage and profound hemodynamic instability. Severe hyponatremia in this context is uncommon and may precipitate neurological manifestations, including seizure, compounding disease complexity and mortality risk. This study aims to describe the clinical course, management, and outcome of a pediatric DSS case complicated by severe symptomatic hyponatremia and seizure. Case Presentation: We report the case of an 8-year-11-month-old boy presenting with fever, abdominal pain, diarrhea, and a generalized tonic–clonic seizure at home. Laboratory findings confirmed secondary dengue infection, hemoconcentration, thrombocytopenia, and severe hyponatremia (Na⁺ 100–122 mEq/L). The patient developed DSS with large-volume ascites and bilateral pleural effusions during the critical phase. Management included fluid resuscitation per WHO protocol, hypertonic saline correction of sodium, albumin infusion, and close hemodynamic and neurological monitoring. Seizure activity resolved with gradual sodium normalization. Conservative management of effusions avoided invasive intervention. The patient was discharged in stable condition on day six with no recurrent neurological events. This case illustrates the diagnostic and therapeutic challenges of managing DSS complicated by severe hyponatremia and seizure. Management requires balancing volume restoration with prevention of sodium dilution and fluid overload, alongside multidisciplinary coordination. Conclusion: Severe hyponatremia with seizure in DSS is rare but life-threatening. Early electrolyte evaluation in dengue patients with neurological symptoms is essential, and individualized management can optimize survival.
Co-Authors Finny Fitry Yani Fitria, Triola Sahputra, Roni Eka