Abstract Ref Number = APCP979
AN UNCOMMON CASE OF SCABIES IN YOUNG INFANT
Sheila Hustadi Budiawan,Riyanti Teresa,Audrey ,Harris Alfan,Melyawati Hermawan
Faculty of medicine Department of Child Health University of Atma Jaya Jakarta Department of Child Health Atma Jaya Hospital Jakarta Department of Dermatology and Venereology Atma Jaya Hospital Jakarta
Background : Scabies infecting neonatal and young infant demonstrates a distinct clinical pattern that differs from its older counterparts making it susceptible to misdiagnosis. This case report presents scabies in a young infant which manifested as sepsis.
Case Presentation Summary : A 41-day-old female presented in outpatient clinic with feeding refusal, weak cry, and poor weight gain for the last 7 days. She also has skin rashes for 3 weeks prior which started as small red lesions on her face and head before spreading to her trunk and extremities; hands and fingers were spared. No history of fever, jaundice, diarrhea, or cough. Her mother and brother had similar pruritic rashes. Her brother who stayed at boarding school had visited home before the rash develop. The baby was born vaginally at term, weighing 3.100 grams, with no perinatal complication. On examination, the baby appeared severely ill with signs of severe dehydration. Small, erythematous macules, papules and pustules were found all over her body; some of which were excoriated. Her lab results showed leucocytosis, thrombocytosis, and mildly increased C-reactive protein level. She was treated with fluid rehydration, intravenous ampicillin and cefotaxime, 4% topical sulphur, 2.5% topical hydrocortisone, and gentamicin cream. After 6 days of treatment, the lesions subsided, feeding tolerance improved and she gained weight. All household contacts were recommended to seek treatment.
Learning Points/Discussion : Scabies in young infant manifested as pleomorphic lesions, commonly accompanied by bacterial secondary infection. Excoriations and burrows, which are common in older individuals, are not seen. Young infants do not exhibit pruritus, but will appear fussy with feeding refusal and poor weight gain. History of possible scabies contacts and differential diagnosis exclusion are crucial.
Keywords: Scabies Young Infant Pleomorphic lesions