Abstract Ref Number = APCP957
CLINICALLY CONGENITAL RUBELLA SYNDROME IN A-6-MONTH OLD GIRL
Yusrizal ,Herry D Nawing ,Ninny Meutia Pelupessy
Department of Child Health Faculty of Medicine Hasanuddin University Dr Wahidin Sudirohusodo Hospital Makassar Indonesia Department of Child Health, Faculty of Medicine, Hasanuddin University, Dr Wahidin Sudirohusodo Hospital, Makassar, Indonesia Department of Child Health, Faculty of Medicine, Hasanuddin University, Dr Wahidin Sudirohusodo Hospital, Makassar, Indonesia
Background : Congenital Rubella Syndrome (CRS) is an illness in infants that results from maternal infection with rubella virus during pregnancy and serious consequences such as miscarriages, stillbirths, and severe birth defects in infants. CRS occurred if nonimmune first trimester pregnant women suffered rubella infection. The estimated incidence of CRS is 0.2 per 1,000 live births per year in Indonesia. The prognosis may have a poor outcome with severe multiple organ damage.
Case Presentation Summary : A-6-month old girl was admitted to hospital with a white spot in her left eye and unable to lift her head. In the first trimester of pregnancy, the mother had fever and red spot in skin was noted. No history of vaccinated against to rubella. Physical examination showed microcephaly with head circumference 39 cm (normal: 40-45cm), cataract on left eye lens, hearing loss, continuous heart murmur, and global developmental delayed. Laboratory findings revealed Anti Rubella Ig M 7,99 (<1,2 IU/ml), Anti Rubella Ig G 216 (<14 IU/ml). Radiology findings revealed cardiomegaly in chest x-ray, Patent Ductus Arteriosus in echocardiography, calcifications in bilateral ganglia basalis and cerebrum hypoplasia in head CT Scan. Auditory brainstem response examination revealed sensoryneural hearing loss with 110 dB scale. The patient was planned to replace the lens, used hearing aid, and had physiotherapy for developmental delayed.
Learning Points/Discussion : It is a full blown case of clinically CRS. Severe multple organ damage in infants can happen if nonimmune first trimester pregnant women suffered rubella infection. The prognosis of the patient was dubious.
Keywords: CRS Cataract Hearing Loss PDA