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A Challenge In Establishing The Etiologic Of Toxic Epidermal Necrolysis In Children Jefrizal Wirman; Gardenia Akhyar; Irdawaty Izrul; Qaira Anum
Proceeding International Conference Of Innovation Science, Technology, Education, Children And Health Vol. 2 No. 1 (2022): Proceeding of The International Conference of Inovation, Science, Technology, E
Publisher : Program Studi DIII Rekam Medis dan Informasi Kesehatan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.62951/icistech.v2i1.33

Abstract

Background: Toxic epidermal necrolysis (TEN) is a rare especially in children, acute and potentially lifethreatening. The etiology of the higher incidence of TEN in various pediatric age groups than in adults is unclear, the cause is multifactorial. TEN have known triggering events, including infections (commonly viral or mycoplasma) drugs/herbs, malignancy, vaccines, and idiopathic. Case report: We reported a case TEN of a 5 years old boy. There was a history of fever and red rash on the patient's hands 5 days ago and taken paracetamol, amoxicilin, chlorpeniramin maleat(CTM), and vitamin C, then a red patch and blisters appears 12 hours later. Physical examination: composmentis, temperature 38,80C. Dermatological state: erythemathous macules, vesicles, bulla, erosions, excoriations, crusts on the most of body. Hyperemic conjunctiva, on oral mucosa there were erythematous oedem, erosion, excoriation and reddish-blackish crust, and erosion of the genitalia. Epidermolysis was about ± 40%. Laboratory examination :leucocyte 5300/mm3 with lymphocytosis. Serum urea increases, serum bicarbonate decreases. The patient was treated dexamethasone intra venous and decreased dose with prednisone oral, patient improved and healed on day 13. Discussion: The diagnosis of TEN in patients is made based on history and physical examination. We can establish a typical diagnosis of TEN from clinical symptoms and physical examination, but to find the etiology is sometimes difficult and requires a deep history and other investigations. The etiology in this case cannot be established because of drugs or infection. To find out, it is necessary to do further tests such as serology or PCR
Vaginitis Gonorrhea on Children: A case series Qaira Anum; Heffi Anindya Putri
Proceeding International Conference Of Innovation Science, Technology, Education, Children And Health Vol. 3 No. 2 (2023): Proceeding of The International Conference of Inovation, Science, Technology, E
Publisher : Program Studi DIII Rekam Medis dan Informasi Kesehatan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.62951/icistech.v3i2.67

Abstract

Background: Vaginitis gonorrhea is sexually transmitted infections (STIs) which caused by Neisseria gonorrhoeae and commonly found in children. Frequently, it indicates the sexual abuse in children. Although infrequent, nonsexual gonorrhea transmission, either from fomites, physical contact or autoinoculation may occur in children. Case report: Three cases of vaginitis gonorrhea on 3, 6 and 8 years old girl with a chief complaint of vaginal discharge that felt no itchy are presented. The history of sexual intercourse or abuse in two cases were denied but they had history of sharing baths and public swimming pool. In one case, there was alleged sexual abuse 6 months ago by her cousin. Physical examination revealed the yellowish odor vaginal discharge and there were no signs of inflammation around they genitalia. There were Gram-negative diplococcal intra and extra cellular. All of Thayer Martin culture revealed a positive result of Neisseria gonorrhoeae. Only one patient performed screening for the other STI, while two patient refused. All of these patients were treated with 125 mg intramuscular ceftriaxone injection but only 1 patient improvement, while 2 others recovered with alternative therapy based on the results of sensitivity test. Discussion : Patients were diagnosed as vaginitis gonorrhea based on physical examination and laboratory results. One case was suspected as sexual abuse while the other were suspected of non-sexual abuse such as fomite. The limitation of this case report are unidentified sources of gonococcal transmission and rejection for completed STIs screening.