scholarly journals Dysentery as the only presentation of COVID-19 in a child: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Marjan Tariverdi ◽  
Nazanin Farahbakhsh ◽  
Hamed Gouklani ◽  
Fatemeh Khosravifar ◽  
Mohammad Tamaddondar

Abstract Introduction The coronavirus disease 2019 (COVID-19) pandemic has caused irreparable damage to society, and the damage continues. Pediatricians are confronted with COVID-19 in a variety of presentations, which may lead to delayed diagnosis and treatment. Early diagnosis of the disease plays an important role in preventing transmission of the virus in the community. Case presentation Here we report a 27-month-old previously healthy Iranian female child who presented with fever and bloody diarrhea, diagnosed with COVID-19 based on contact history, exclusion of enteric bacterial pathogens and parasites, and positive stool and nasopharyngeal severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reverse transcriptase polymerase chain reaction (RT-PCR) tests. The patient had viral shedding for more than a month. Conclusions The pediatric population usually does not present with typical clinical features of COVID-19, which are respiratory involvement. Dysentery may be the only presentation of this disease, and long-term isolation should be considered, as the viral shedding may last for more than a month.

2021 ◽  
Vol 2 (2) ◽  
Author(s):  
Richard J. Barohn ◽  
Mary Hindle ◽  
Lauren Peck ◽  
Syed Hasan Raza Naqvi

  Since December 2019, COVID 19 pandemic has devastated communities across the world. As number of patients recovered from COVID 19 continue to rise, question of acquired immunity versus chances of re-infection becomes critical to understand the future spread of infection. Here, we present a case of a patient previously recovered from COVID-19, develops new symptoms concerning for possible re-infection with positive reverse transcriptase-polymerase chain reaction (RT-PCR) after few months of initial infection.  


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Fang Wang ◽  
Ya-Qin Tan ◽  
Jing Zhang ◽  
Gang Zhou

Abstract Background Oral lichen planus (OLP) is a chronic mucocutaneous disease characterized by adult predominance and a prolonged course. However, it is rare in the pediatric population with familial aggregation. Case presentation A 3-year-old boy presented with pain and irritation on the oral mucosa while contacting spicy food for 2 months. Oral examination showed widespread whitish reticular and papular lesions on the lips, the dorsum of the tongue, and bilateral buccal mucosa, with diffuse erosions covered with pseudomembrane on the buccal mucosa. The boy’s parents were examined to exhibit white reticular and plaque-like lesions on their oral mucosa. The three patients were clinically diagnosed as affected by OLP and histopathologically confirmed. The boy underwent topical treatment with recombinant bovine basic fibroblast growth factor (rb-bFGF) gel, and oral lesions gradually resolved and healed. Neither of his parents received treatment. During the subsequent follow-ups, none of three patients underwent any medical treatment. Fortunately, their lesions had almost faded over 8 years. Conclusions Our case emphasizes that pediatric OLP should be recorded with family history. Besides, long-term periodic follow-up is recommended in pediatric patients with OLP for monitoring any changes in lesions.


Author(s):  
Tugba Erat ◽  
Müge Atar ◽  
Tugba Kontbay

AbstractObjectivesCoronavirus disease (COVID-19) rapidly spread worldwide in a few months and was declared as a worldwide pandemic by WHO in March 2020. Transient benign hyperphosphatasemia (THI) is a benign condition associated with marked elevation of alkaline phosphatase (ALP) without any other kidney, bone, and liver pathologies.Case presentationHerein, we report a previously healthy 16-month-old female patient who developed a secondary transient benign hyperphosphatasemia associated with SARS-CoV-2. Patient whole family’s SARS-CoV-2 real-time reverse transcription-polymerase chain reaction (RT-PCR) results were positive. Since THI is a diagnosis of exclusion, other reasons that may cause ALP elevation should be ruled out. ALP activity decreased and turned to normal ranges within the following month. THI has been reported to be in association with various conditions. Its relationship with many viruses has been reported previously.ConclusionsIf ALP elevation is detected in patients with COVID 19 due to the increasing number of infections, THI should be considered if there is no other accompanying pathology.


2021 ◽  
Vol 25 (2) ◽  
pp. 258-260
Author(s):  
V. M. Dudnyk ◽  
V. Н. Furman ◽  
I. I. Andrikevych ◽  
N. O. Buglova ◽  
O. V. Кutsak ◽  
...  

Annotation. Peculiarities of clinical course and differential diagnosis of multisystem inflammatory syndrome (MIS-C) in children with coronavirus infection are described. The main features of this disease are long-term fever, multiorgan dysfunction, laboratory signs of inflammation and positive tests for SARS-CoV-2 (polymerase chain reaction using reverse transcription (RT-PCR), antigen test or positive serological test). The criteria of the World Health Organization (WHO) and the US Centers for Disease Control and Prevention (CDC) are used to confirm the MIS-C diagnosis.


2021 ◽  
Author(s):  
Farahnaz Joukar ◽  
Tofigh Yaghubi Kalurazi ◽  
Mahmoud Khoshsorour ◽  
Sonbol Taromian ◽  
Lida Mahfoozi ◽  
...  

Abstract Background: This study was conducted to determine the persistence of SARS-CoV-2 RNA in the nasopharynx, blood, urine and stool of patients with COVID-19.Methods: In this hospital based longitudinal study, 100 confirmed COVID-19 cases were recruited, between March and August 2020 in Guilan province (Northern Iran). Nasopharynx, blood, urine and stool samples were obtained from each patient at the time of hospital admission, discharge, followed by one week after discharge and every 2 weeks until all samples were negative for SARS-CoV-2 RNA by reverse transcription polymerase chain reaction (RT-PCR). Survival analysis was used to identify the duration of virus persistence over time.Results: Positive blood, urine, stool RT-PCR were detected in 24%, 7% and 6% of patient respectively. The median duration of virus persistence in blood, urine and stool were 7 days (95% CI: 6.07–7.93), 6 days (95% CI: 4.16–8.41) and 13 days, 95% CI: 6.96–19.4), respectively. The maximum duration of virus persistent in blood, urine and stool were 17, 11 and 42 days from admission, respectively. Conclusions: According our results, until obtaining definite evidence of the duration of infective viral shedding, prolonged isolation duration at least 25 days from admission to hospital and strict hygienic measures for about one month were recommended.


2020 ◽  
Author(s):  
Abhijeet Singh ◽  
Ayush Gupta ◽  
Kamanashish Das

Abstract Background: The ongoing pandemic of novel coronavirus disease 2019 (COVID-19) has received worldwide attention by becoming a major global health threat. We encountered one case with COVID-19 and tuberculosis (TB) coinfection which has not been frequently reported. Case presentation: A 76 year old female presented with acute respiratory symptoms superimposed on chronic symptoms, suggestive to have pneumonia. Oropharyngeal throat swab sample for COVID-19 was positive as detected by real-time reverse-transcriptase–polymerase-chain-reaction (RT-PCR) assay. GeneXpert Ultra detected Mycobacterium tuberculosis complex with Rifampicin resistance indeterminate. Patient was treated with appropriate management. Conclusion: Clinicians should suspect coinfection with TB during ongoing pandemic of COVID-19 as therapeutic strategies need to be determined timely to improve outcome and prevent transmission in community.


PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0255263
Author(s):  
Victor Arévalos ◽  
Luis Ortega-Paz ◽  
Diego Fernandez-Rodríguez ◽  
Víctor Alfonso Jiménez-Díaz ◽  
Jordi Bañeras Rius ◽  
...  

Background Patients presenting with the coronavirus-2019 disease (COVID-19) may have a high risk of cardiovascular adverse events, including death from cardiovascular causes. The long-term cardiovascular outcomes of these patients are entirely unknown. We aim to perform a registry of patients who have undergone a diagnostic nasopharyngeal swab for SARS-CoV-2 and to determine their long-term cardiovascular outcomes. Study and design This is a multicenter, observational, retrospective registry to be conducted at 17 centers in Spain and Italy (ClinicalTrials.gov number: NCT04359927). Consecutive patients older than 18 years, who underwent a real-time reverse transcriptase-polymerase chain reaction (RT-PCR) for SARS-CoV2 in the participating institutions, will be included since March 2020, to August 2020. Patients will be classified into two groups, according to the results of the RT-PCR: COVID-19 positive or negative. The primary outcome will be cardiovascular mortality at 1 year. The secondary outcomes will be acute myocardial infarction, stroke, heart failure hospitalization, pulmonary embolism, and serious cardiac arrhythmias, at 1 year. Outcomes will be compared between the two groups. Events will be adjudicated by an independent clinical event committee. Conclusion The results of this registry will contribute to a better understanding of the long-term cardiovascular implications of the COVID19.


PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0252217
Author(s):  
Susan P. Phillips ◽  
Xuejiao Wei ◽  
Jeffrey C. Kwong ◽  
Jonathan Gubbay ◽  
Kevin L. Schwartz ◽  
...  

Introduction There is an evidence gap regarding the duration of SARS-CoV-2 shedding and of its variability across different care settings and by age, sex, income, and co-morbidities. Such evidence is part of understanding of infectivity and reinfection. We examine direct measures of viral shedding using a linked population-based health administrative dataset. Methods Laboratory and sociodemographic databases for Ontario, Canada were linked to identify those testing positive (RT-PCR) between Jan. 15 and April 30, 2020 who underwent subsequent testing by May 31, 2020. To maximise use of available data, we computed two shedding duration estimates defined as the time between initial positive and most recent positive (documented shedding) or second of two negative tests (documented resolution). We also report multivariable results using quantile regression to examine subgroup differences. Results In Ontario, of the 16,595 who tested positive before April 30, 2020, 6604 had sufficient subsequent testing to allow shedding duration calculation. Documented shedding median duration calculated in 4,889 (29% of 16,595) patients was 19 days (IQR 12–28). Documented resolution median duration calculated in 3,219 (19% of the 16,595) patients was 25 days (IQR 18–34). Long-term care residents had 3–5 day longer shedding durations using both definitions. Shorter documented shedding durations of 2–4 days were observed in those living in higher income neighbourhoods. Shorter documented resolution durations of 2–3 days were observed at the 25th% of the distribution in those aged 20–49. Only 11.5% of those with definitive negative test results reverted to negative status by day 14. Conclusions Viral shedding continued well beyond 14 days among this large subset of a population-based group with COVID-19, and longer still for long-term care residents and those living in less affluent neighborhoods. Our findings do not speak to duration of infectivity but are useful for understanding the expected duration of RT-PCR positivity and for identifying reinfection.


2021 ◽  
Author(s):  
Javier García-Abellán ◽  
Sergio Padilla ◽  
Marta Fernández-González ◽  
José A. García ◽  
Vanesa Agulló ◽  
...  

ABSTRACTObjectiveLong-term data following SARS-CoV-2 infection are limited. We aimed to characterize the medium and long-term clinical, virological, and immunological outcomes after hospitalization for COVID-19, and to identify predictors of long-COVID.MethodsProspective, longitudinal study conducted in COVID-19 patients confirmed by RT-PCR. Serial blood and nasopharyngeal samples (NPS) were obtained for measuring SARS-CoV-2 RNA and S-IgG/N-IgG antibodies during hospital stay, and at 1, 2 and 6 months post-discharge. Genome sequencing was performed where appropriate. Patients filled out a COVID19-symptom-questionnaire (CSQ) at 2-month and 6-month visits, and those with highest scores were characterized.ResultsOf 146 patients (60% male, median age 64 years) followed-up, 20.6% required hospital readmission and 5.5% died. At 2-months and 6-months, 9.6% and 7.8% patients, respectively, reported moderate/severe persistent symptoms. SARS-CoV-2 RT-PCR was positive in NPS in 11.8% (median Ct=38) and 3% (median Ct=36) patients at 2-months and 6-months, respectively, but no reinfections were demonstrated.Antibody titers gradually waned, with seroreversion occurring at 6 months in 27 (27.6%) patients for N-IgG and in 6 (6%) for S-IgG. Adjusted 2-month predictors of the highest CSQ scores (OR [95%CI]) were lower peak S-IgG (0.80 [0.66-0.94]) and higher WHO-severity-score (2.57 [1.20-5.86]); 6-month predictors were lower peak S-IgG (0.89 [0.79-0.99]) and female sex (2.41 [1.20-4.82]); no association was found with prolonged viral shedding.ConclusionsLate clinical events and persistent symptoms in the medium and long term occurred in a significant proportion of patients hospitalized for COVID-19. Gender, severity of illness and weaker antibody responses, but not viral shedding, were associated with long-COVID.SummaryThis study characterizes the long-term clinical, virological, and immunological outcomes following COVID-19 hospitalization. We found a significant proportion of late clinical events and persistent symptoms. Gender, severity of illness and weaker antibody responses, but not viral shedding, predicted long-COVID.


2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Bereket Fantahun ◽  
Seblewongel Desta

Background. McCune–Albright syndrome (MAS) is a rare heterogeneous genetic disorder that is characterized by a triad of polyostotic fibrous dysplasia (FD), café au lait spots (CAL), and multiple hyperfunctional endocrinopathies. In general, it is diagnosed clinically. From the triads, two of the findings are enough to make the diagnosis, but genetic testing can be done if it is available. Case Presentation. We report a female child who was symptomatic since the neonatal period with skin hyperpigmentation, breast enlargement, and vaginal bleeding. She was diagnosed with MAS at the age of five years. She had pathological fractures at multiple sites and had raised thyroid hormones since the age of 3½ years. The child developed severe morbidity as the result of delayed diagnosis and currently became wheelchair dependent. Conclusion. Thorough patient evaluation and appropriate interpretation of findings are crucial steps for timely diagnosis of MAS and better patient care outcomes.


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