Abstract Ref Number = APCP738
A GIRL WITH DIPHTERIA AND ACUTE NEPHRITIS A CASE REPORT
Pridania ayuningtyas,Rustam Siregar,Husnia Auliyatul Umma
Department of Child Health Faculty of Medicine Sebelas Maret University Moewardi General Hospital Surakarta
Background : Diphtheria is an acute toxic infection caused by Corynebacterium diphtheriae. Mucosa and human skin are the habitats of C. diphtheriae. The major airborne spread via direct contact with respiratory secretions and exudate from skin lesions. Clinical manifestations of diphtheria depend on the immunity, the site of infection, the production and distribution of toxins. Mostly diphtheria occursin respiratory system that is in the tonsil or pharynx (94%), nose and larynx.
Case Presentation Summary : A 13 years old girl presented to emergencydepartement with a high fever, sweating, non spastic swelling in the neck. The patient snores when sleeping and she had inomplete immunization. Physical examination revealed hyperemic T3-T3 tonsils, covered with a grayish white layer, hyperemic pharynx, visible gray layers in pharynx, tonsils, uvula and palate. The layer bled with provocation. Bullneck was observed. Urinalysis obtained proteinuria. Urology Ultrasoography demonstrated bilateral nephritis.
Learning Points/Discussion : One of the risk factors for the occurrence of diphtheria is incomplete immunization as scheduled by Ministry of health and Indonesian Pediatric Society. Classical clinical manifestations of diphtheria are sore throat, pseudomembrane, and bullneck. They usually appears two to seven days after infection. Clinical symptoms of diphtheria include fever, chills, fatigue, bluish skin, sore throat, cough, headache, swallowing pain, breathing difficulty, rapid breathing, foul breath and lymphadenopathy. Diphteria complication may also include cardiac arrhythmias, myocarditis, nephritis and cranial and peripheral nerve palsies.Antibiotics should be given to the person in contact with the patient and erythromycin may be given.
Keywords: Diphteria Acute nephritis Immunization