Ref Number = PITIKA-ASPR0323
Andi Rasdiana, Amiruddin L, Rahmawaty
Background. A lung abscess is an uncommon respiratory problem in childhood. The incidence is 0.7 per 100.000 admissions in a year. Primary lung abscess usually occurs in healthy children, whereas secondary developing in a child with predisposing factors such as aspiration, pneumonia, cystic fibrosis, gastroesophageal reflux, or immunodeficiency. Pityriasis versicolor is a superficial fungal infection with predisposing factors include a humid environment, excessive sweating, an excess of lipid-containing sebaceous secretions, malnutrition, immunosuppression, and genetic predisposition.
Objective. To report a case of lung abscess accompanied with pityriasis versicolor in a 13-years-3-months’ malnourished child.

Case. A 13-years-3-months old male child was admitted with productive cough for 1 weeks. Also chest pain on the right worsening by cough. There is fever, and history of recurrent fever for 4 months. He had anorexia, lethargy but no history of weight loss. No history exposing with adult tuberculosis patient. He also presented with numerous hypopigmented lesion on the whole body of approximately 6 months’ duration. He never being exposed to other with the same conditions. Physical examination revealed malnourished, consciousness. There are fever, tenderness on the right hemithorax, decreasing breath sound and vocal fremitus, piano ribs, and muscle wasting. He had numerous sharply demarcated white macules and patches on generalisata region, covered with a fine scale. TB score is 4. Laboratory examination showed leukocytosis, anemia, negative Tuberculin test, negative sputum microscopy, negative gene Xpert. Radiological sign of air-fluid level seen in both chest X-ray and contrast CT. He was treated with antibiotics and underwent abscess draination, management of malnutrition, along with topical antifungal cream.

Conclusion. A case of lung abscess accompanied with pityriasis versicolor in a 13-years-3-months’ malnourished child was reported. The diagnosis was based on history taking, physical examination, laboratory and radiological findings. The prognosis is dubia.
Keywords: Lung abscess, pityriasis versicolor, malnourished.
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