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ANAK AGUNG DEWI ADNYA SWARI
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Health Professions Medicine & Pharmacology Public Health

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DIAGNOSING OCULAR MALINGERING IN CHILDREN WITH SIMPLE TEST: IS IT POSSIBLE? Poster Presentation - Case Report - Resident KEVIN ANGGAKUSUMA HENDRAWAN; NI MADE AYU SURASMIATI; I WAYAN EKA SUTYAWAN; ANAK AGUNG DEWI ADNYA SWARI; MADE KUSUMA WARDANI
Majalah Oftalmologi Indonesia Vol 49 No S2 (2023): Supplement Edition
Publisher : The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami))

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35749/c3exwd43

Abstract

Introduction : Malingering is a condition in children which need a thorough and meticulous examination to diagnose the condition. According to several publication, simple test can be done to diagnose this condition without necessarily performing imaging and electrophysiologic tests. Case Illustration : An 8-year-old male patient, came to eye clinic with sudden visual loss on both eyes for the last 3 days, following pain on both eyes and headache which fluctuating over the last 3 weeks. Patient insisted on wearing black glasses during examinations. Preliminary examination revealed visual acuity no light perception on both eyes. Slit lamp examination and pupillary reflex were normal, fundus examination revealed normal fundus. We tried to do surprise test by suddenly swaying hand towards patient’s eyes and record a visual response. Afterwards we asked patient’s parent to wait outside while performing LEA test which revealed visual acuity 6/6 on both eyes. Further history taking revealed that patient got bullied on school that makes him try to avoid attending school. Discussion : Patient with malingering usually come with decreased vision but seldomly come with blindness. Though it was quite challenging, doing some simple test available in daily practice such as surprise test can help us to diagnose the suspicion. Handling such patient needs a cautious analysis towards patient’s condition and gentle approach towards the patient. It is crucial to rule out organic condition before diagnosing patient with malingering. Conclusion : Simple test such as surprise test can be done in assisting malingering diagnosis when carefully done with the support of thorough history taking and physical
Management of Streptococcus pyogenes Preseptal Cellulitis in Multisystem Inflammatory Syndrome in Children (MISC): Poster Presentation - Case Report - Resident ANAK AGUNG DEWI ADNYA SWARI; N.K. Niti Susila; I Gusti Ayu Made Juliari; Ida Ayu Ary Pramita
Majalah Oftalmologi Indonesia Vol 49 No S2 (2023): Supplement Edition
Publisher : The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami))

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35749/rsy2ek75

Abstract

Introduction : Preseptal cellulitis were more common in children than adults. Preseptal cellulitis was an infection involving the anterior part of the orbita septum. Management of preseptal cellulitis, especially in children, were important to save visual function. Case Illustration : A boy, 1 year 8 months, was complained by his mother with swollen and redness on both eyes. The patient has a history of Multisystem Inflammatory Syndrome in Children (MISC) and Global Developmental Delay (GDD). Both eyes were edema, hyperemia, excoriation, bleeding, tenderness on eyelid, and conjunctival injection. Blood Culture examination results showed Streptococcus pyogenes bacteria. Patient was receiving therapy of antibiotics cefoperazone-sulbactam, amikacin, methylprednisolone intravena, enoxaparin subcutaneous injection, moxifloxacin and prednisolone asetat eye drops during hospitalization at Prof. Dr. I.G.N.G. Ngoerah General Hospital. Discussion : A patient with fever and respiratory tract infection was diagnosed with preseptal cellulitis. Preseptal cellulitis is a common infection of the eyelid and periorbita soft tissues characterized by acute eyelid erythema and edema. Antibiotic therapy had been started before blood culture examination. This study discusses toddler with preseptal cellulitis treated with antibiotics showing good results. ConclusionPreseptal cellulitis due tue multisystem inflammatory syndrome in children was an infection of the soft tissues of the eye that requires a multidisciplinary approach in management therapy. Early detection and adequate therapy have been proven to significantly improve patient survival rates and quality of life.
Co-Authors I Gusti Ayu Made Juliari I Wayan Eka Sutyawan Ida Ayu Ary Pramita KEVIN ANGGAKUSUMA HENDRAWAN MADE KUSUMA WARDANI N.K. Niti Susila Ni Made Ayu Surasmiati