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Suryaningsih, Putu Siska
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Necrotizing enterocolitis, sepsis, and diarrhea due to cow's milk allergy in a full-term infant with Hypothyroidism: a case report Arumndari, Runi; Putri, Asterisa Retno; Liman, Claudia Natasha; Suryaningsih, Putu Siska
Pediatric Sciences Journal Vol. 4 No. 2 (2023): (Available online: 1 December 2023)
Publisher : Medical Faculty of Brawijaya University, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/pedscij.v4i2.58

Abstract

Introduction: Necrotizing enterocolitis (NEC) remains one of neonates' most common gastrointestinal diseases. NEC is allegedly to be a multifactorial disease. Some of the predisposing factors are cow’s milk formula (CMF) feeding or not being breast-fed from birth, sepsis, and Hypothyroidism. Case: An 8-day-old full-term baby girl was admitted with an initial diagnosis of sepsis and acute diarrhea due to cow's milk allergy. She had never been breast-fed from birth. She also had a fever, signs of mild-to-moderate dehydration, a C-Reactive Protein (CRP) level at 114, leukocyte 6.280/ul, platelet counts 477.000/ul, and fat on the stool test. She was given Cefotaxime, probiotics, zinc, and a hypoallergenic milk formula. Her condition worsened on the 4th day of hospitalization. She showed abdominal distention, bradypnea, and vomiting. She was then fasting, required a nasal cannula oxygen, and undergone several laboratory examinations showing leukocyte 4.980/ul, platelet count 54.300/ul, and a positive fecal occult blood test. An abdominal x-ray showed an increased bowel gas. She was then diagnosed with grade I NEC, and the antibiotic was changed to Meropenem, added with Metronidazole. She also undergone a thyroid hormone screening, had a TSH level of 6.36 and FT4 1.23, and thus was given Levothyroxine. Her condition improved gradually. After being given Meropenem for 7 days, she was discharged on the 12th day of hospitalization in good condition. Two days later, during the clinic’s follow-up, she was in good health, and it was planned that she would do a follow-up examination for thyroid hormones a month later. Conclusion: Cow’s milk allergy can be severe enough to develop sepsis. Meanwhile, both are predisposing factors for NEC. Hypothyroidism can also be a predisposing factor by causing a decrease in intestinal motility, which plays a role in bacterial overgrowth. A study in animals showed that bacteria play an important role in the development of NEC because NEC will not occur in a germ-free environment but can only develop after exposure to microbes. Conservative treatment for NEC includes broad-spectrum antibiotics, bowel rest, and abdominal decompression.
Analisis Faktor-Faktor yang Memengaruhi Kematian Neonatus: Studi Retrospektif di Rumah Sakit Wangaya Denpasar Predani, Ni Luh Putu Diaswari; Bikin Suryawan, I Wayan; Suryaningsih, Putu Siska
Sari Pediatri Vol 25, No 5 (2024)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp25.5.2024.322-7

Abstract

Latar belakang. Kematian pada masa neonatal masih menjadi penyebab kematian tertinggi pada bayi dan balita di Indonesia pada tahun 2021 dengan angka kematian bayi di Indonesia 12 dari 1000 bayi lahir hidup. Upaya untuk menurunkan angka kematian neonatus di Indonesia terus dilakukan dengan target 9 per 1000 kelahiran pada tahun 2025. Berat badan lahir rendah, asfiksia, prematuritas, kelainan kongenital serta sepsis menjadi faktor risiko tertinggi kejadian kematian neonatus. Tujuan. Penelitian ini bertujuan untuk mengetahui faktor-faktor yang berhubungan dengan kematian neonatus di Rumah Sakit Umum Daerah Wangaya, Denpasar.Metode. Penelitian ini menggunakan metode analitik observasional cross-sectional dengan data sekunder menggunakan rekam medis. Teknik pengambilan sampel adalah dengan consecutive sampling dengan total sampel 114 neonatus yang memenuhi kriteria inklusi dan eksklusi. Variabel yang diteliti adalah berat badan lahir rendah, asfiksia, prematuritas, kelainan kongenital dan infeksi. Data dianalisis dengan SPSS versi 23 mengunakan uji Chi-square. Hubungan antar variabel dikatakan signifikan apabila nilai p<0,05 dengan interval kepercayaan 95%.Hasil. Faktor yang berhubungan dengan kematian neonatus adalah berat badan lahir rendah (p=0,001 dan RP 2,02 dengan IK 95%: 1,18-3,07), asfiksia (p=0,000 dan RP 2,56 dengan IK 95%: 1,7-3,85) dan usia kehamilan kurang bulan (p=0,000 dan RP 2,52 dengan IK 95%: 1,68-3,89). Sedangkan kelainan kongenital dan infeksi tidak berhubungan secara bermakna dengan kejadian kematian neonatus (p=0,1 RP 1,6; 95%; IK 95%: 1,09-2,44 dan p=0,5 RP 1,14; IK 95%: 0,7-1,68)Kesimpulan. Disimpulkan bahwa ada hubungan yang bermakna antara berat badan lahir rendah, asfiksia dan usia kehamilan kurang bulan dengan kematian neonatus di Rumah Sakit Umum Daerah Wangaya, Denpasar.
Necrotizing Enterocolitis, Sepsis, dan Diare Akibat Alergi Susu Sapi pada Bayi Cukup Bulan dengan Hipotiroidisme Arumndari, Runi; Retno Putri, Asterisa; Liman, Claudia Natasha; Suryaningsih, Putu Siska
Cermin Dunia Kedokteran Vol 51 No 8 (2024): Penyakit Dalam
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v51i8.981

Abstract

Necrotizing enterocolitis (NEC) remains one of the most common gastrointestinal diseases in neonates, with high morbidity and mortality. An 8-day-old full-term baby girl was admitted with an initial diagnosis of sepsis and acute diarrhea due to a cow’s milk allergy. Her condition worsened on the 4th day of hospitalization with abdominal distention, bradypnea, and vomiting. An abdominal x-ray showed increased bowel gas. She had a slightly lowered FT4. The findings met Bell’s criteria for the diagnosis of NEC. After being given meropenem and levothyroxine for 7 days, she was discharged on the 12th day of hospitalization in good condition. NEC is allegedly to be a multifactorial disease, with predisposing factors of cow’s milk formula (CMF) feeding or not breast-fed since birth, sepsis, and hypothyroidism. The combination of clinical symptoms, radiologic findings, and risk factor tracing is important in the diagnosis and management of NEC.
Komplikasi letal pada bayi sangat prematur dengan sifilis kongenital Gozali, Ferry Suganda; Liman, Claudia Natasha; Suryaningsih, Putu Siska
Cermin Dunia Kedokteran Vol 51 No 5 (2024): Kedokteran Umum
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v51i5.1093

Abstract

Introduction: Congenital syphilis is a multi-organ infection caused by Treponema pallidum and transmitted from mother to fetus through uteroplacental circulation. Congenital syphilis is one of the main contributors to neonatal deaths in the United States. Case: A male infant was born by cesarean delivery from a G1P0 mother at 28 weeks of gestational age because of premature rupture of the membrane and anhydramnion. The mother had an untreated latent syphilis infection. The birthweight was 1,400 grams, the head circumference was 25 cm, and the body length was 35 cm. His APGAR score was 3-3-5 with severe asphyxia and respiratory distress syndrome. Multiple abnormalities were found, and the VDRL titre was 1/128. Cardiac-pulmonary resuscitation started immediately with 0.15 mg epinephrine through an intraendotracheal tube and continued with 0.02 mg epinephrine through intravenous access every 3 minutes. The baby was declared dead after 30 minutes of resuscitation. Conclusion: Congenital syphilis can cause lethal complications due to untreated latent syphilis suffered by his mother. The mother should undergo antenatal screening to prevent congenital syphilis.
Co-Authors Arumndari, Runi Gozali, Ferry Suganda I Wayan Bikin Suryawan Liman, Claudia Natasha Predani, Ni Luh Putu Diaswari Putri, Asterisa Retno Retno Putri, Asterisa