scholarly journals MANIFESTATIONS OF ACUTE APPENDICITIS IN A CHILD WITH MULTISYSTEMIC INFLAMMATORY SYNDROME ASSOCIATED WITH SARS-COV-2: A CLINICAL CASE

2021 ◽  
Vol 11 (4(42)) ◽  
pp. 102-106
Author(s):  
O. Panchenko ◽  
H. Pavlyshyn ◽  
M. Halych ◽  
V. Bodnarchuk
Keyword(s):  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Inflammatory Disease ◽  
Clinical Case ◽  
Gastrointestinal Symptoms ◽  
Transmission Mechanism ◽  
Oral Transmission ◽  
Coronavirus Infection ◽  
Loss Of Appetite ◽  
Inflammatory Syndrome

The pandemic of the coronavirus disease caused by SARS-CoV-2, continues. The airborne way stays the main one in transmission of coronavirus infection. However, the fecal-oral transmission mechanism plays a significant role. Gastrointestinal symptoms of SARS-CoV-2 infection include loss of appetite, diarrhea, vomiting, and abdominal pain, which can often mask other conditions and require diagnostic search and differential diagnosis.The presence of multisystem inflammatory syndrome, according to the international classification, indicates a critical course of infection caused by SaRS-CoV-2, and can develop in children a few weeks after infection. The acute symptoms from the digestive tract side are one of the criteria of the multisystem inflammatory syndrome.The article presents a clinical case of acute appendicitis in a child with multisystem inflammatory disease associated with SARS-COV-2 infection, evaluates the dynamics of the main manifestations following the treatment, and analyzes the literature on such cases, emphasizing the features and difficulties of diagnostic search.

COVID-19 aus der Sicht der Gastroenterologie

2020 ◽  
Vol 145 (15) ◽  
pp. 1033-1038
Author(s):  
Christian Schulz ◽  
Julia Mayerle ◽  
Hans Christian Stubbe ◽  
Simon Sirtl ◽  
Markus M. Lerch ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Respiratory Symptoms ◽  
Gastrointestinal Symptoms ◽  
Clinical Routine ◽  
Fecal Samples ◽  
Oral Transmission ◽  
Number Of Patients ◽  
New Variant ◽  
Therapeutic Procedures ◽  
Loss Of Appetite

AbstractCOVID 19, caused by SARS-CoV2, a new variant of coronaviruses, typically presents with respiratory symptoms. However, in a significat number of patients different organs are involved in the disease, often including gastrointestinal symptoms. These could include loss of appetite, vomiting, abdominal pain and diarrhea, with diarrhea being associated with a more severe course of COVID-19. Because viral RNA can be detected in fecal samples, some implications for clinical routine in diagnostic and therapeutic procedures are grown. Until yet, no clear evidence is given regarding fecal-oral transmission of SARS-CoV2.

scholarly journals A Case of Multisystem Inflammatory Syndrome in Children Presenting as Acute Appendicitis and Pancreatitis

PRILOZI ◽  
2021 ◽  
Vol 42 (2) ◽  
pp. 95-101
Author(s):  
Lidija Kareva ◽  
Katarina Stavrik ◽  
Kristina Mironska ◽  
Arjeta Hasani ◽  
Sonja Bojadzieva ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Pediatric Patients ◽  
Close Contact ◽  
Multiorgan Failure ◽  
Gastrointestinal Symptoms ◽  
Gastrointestinal Diseases ◽  
Serological Testing ◽  
Inflammatory Syndrome ◽  
Pcr Test

Abstract Multisystem Inflammatory Syndrome in Children (MIS-C) is characterized by an inflammation with fever, elevated inflammatory markers, conjunctivitis, rash, impaired coagulation, gastrointestinal symptoms and cardiac abnormalities that may progress to multiorgan failure. The presence of a positive COVID-19 antigen via a PCR test, serological testing for antibodies or close contact with a person diagnosed with COVID-19 helps differentiate MIS-C from other diseases. Gastrointestinal symptoms are recognized to be associated with COVID-19 infection or MIS-C in children, presenting as abdominal pain, gastrointestinal infection with watery stools, appendicitis, ileitis, pancreatitis and hepatitis, confusing the diagnosis with other gastrointestinal diseases. In this case report, we describe an 11 year old boy with MIS-C, who presents acute phlegmona of the appendix for which he undergoes appendectomy, accompanied with acute pancreatitis. These manifestations of MIS-C in our patient resolved without additional complications after a 2 month follow up. We call attention to MIS-C presenting in pediatric patients with fever and abdominal pain which might be caused by appendicitis and pancreatitis, and we recommend abdominal imaging and additional laboratory investigation to promote earlier diagnosis.

scholarly journals Dermatological Manifestations of COVID-19 in Children

2020 ◽  
Vol 7 (2) ◽  
Author(s):  
Vivek Athwani ◽  
Sunil Gothwal
Keyword(s):  
Toxic Shock Syndrome ◽  
Gastrointestinal Symptoms ◽  
Skin Lesions ◽  
Skin Involvement ◽  
Toxic Shock ◽  
Cutaneous Manifestations ◽  
Systemic Involvement ◽  
Atypical Kawasaki Disease ◽  
Coronavirus Infection ◽  
Inflammatory Syndrome

: Coronavirus infection 2019 (COVID-19) primarily has a respiratory system and multi-systemic involvement. Respiratory and gastrointestinal symptoms are predominantly seen in children. In adults, few COVID-19 cases are reported with cutaneous manifestations. Although children are less severely affected by COVID-19, there is increasing evidence for skin involvement, which is in the form of chilblain (e.g., lesions, vesicular, and maculopapular) and erythema multiforme (e.g., rash). Also, few COVID-19 cases are presented with a clinical picture of atypical Kawasaki disease and toxic shock syndrome, later defined as pediatric multisystem inflammatory syndrome (PMIS). The present study aims to summarize various skin lesions with COVID-19.

scholarly journals Global prevalence of prolonged gastrointestinal symptoms in COVID-19 survivors and potential pathogenesis: A systematic review and meta-analysis

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 301
Author(s):  
Fauzi Yusuf ◽  
Marhami Fahriani ◽  
Sukamto S. Mamada ◽  
Andri Frediansyah ◽  
Azzaki Abubakar ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Meta Analysis ◽  
Gastrointestinal Symptoms ◽  
Global Prevalence ◽  
Number Of Patients ◽  
Gi Symptoms ◽  
Study Characteristics ◽  
Loss Of Appetite ◽  
Cumulative Prevalence

Background: This study aimed to determine the cumulative prevalence of prolonged gastrointestinal (GI) symptoms, including nausea, vomiting, diarrhea, lack of appetite, abdominal pain, and dysgeusia, in survivors of both mild and severe COVID-19 worldwide and to discuss the potential pathogenesis.   Methods: Three databases (PubMed, Scopus, and Web of Science) were searched for relevant articles up to January 30, 2021. Data on study characteristics, clinical characteristics during follow-up, the number of patients with prolonged GI symptoms, and total number of COVID-19 survivors were retrieved according to PRISMA guidelines. The quality of eligible studies was assessed using the Newcastle-Ottawa scale. The pooled prevalence of specific prolonged GI symptoms was calculated and the association between COVID-19 severity and the occurrence of prolonged GI symptoms was assessed if appropriate.   Results: The global prevalence of prolonged nausea was 3.23% (95% CI: 0.54%–16.53%) among 527 COVID-19 survivors. Vomiting persisted in 93 of 2,238 COVID-19 survivors (3.19%, 95% CI: 1.62%–6.17%) and prolonged diarrhea was found in 34 of 1,073 survivors (4.12%, 95% CI: 1.07%–14.64%). A total of 156 patients among 2,238 COVID-19 survivors (4.41%, 95% CI: 1.91%–9.94%) complained of persistent decreased or loss of appetite. The cumulative prevalence of prolonged abdominal pain was 1.68% (95% CI: 0.84%–3.32%), whereas persistent dysgeusia was identified in 130 cases among 1,887 COVID-19 survivors (7.04%, 95% CI: 5.96%–8.30%). Data was insufficient to assess the relationship between COVID-19 severity and the occurrence of all prolonged GI symptoms.   Conclusion: Persistent GI symptoms among COVID-19 survivors after discharge or recovery raises a concern regarding the long-term impact of the COVID-19 infection on the quality of life of the survivors. Despite several potential explanations proposed, studies that aim to follow patients after recovery from COVID-19 and determine the pathogenesis of the prolonged symptoms of COVID-19 survivors are warranted.   PROSPERO registration: CRD42021239187.

COVID-19 associated multisystem inflammatory syndrome in children mimicking acute appendicitis - how to differentiate and conduct pediatric patients during the pandemic? - Proposal of a management flowchart

2021 ◽  
Vol 48 ◽  
Author(s):  
LORAINE ENTRINGER FALQUETO ◽  
CAROLINA MARTINS VISSOCI ◽  
ISABELLA CRISTINA BONETTO FERREIRA ◽  
AMANDA GINANI ANTUNES ◽  
FERNANDO ANTÔNIO BERSANI AMADO ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Acute Abdomen ◽  
Initial Phase ◽  
Pediatric Patients ◽  
Pediatric Population ◽  
Gastrointestinal Symptoms ◽  
Signs And Symptoms ◽  
Clinical History ◽  
Pediatric Hospital ◽  
Inflammatory Syndrome

ABSTRACT Introduction: the new coronavirus pandemic has been a reality throughout 2020, and it has brought great challenges. The virus predominantly manifests in the pediatric population with mild symptoms. However, an increase in the incidence of Multisystemic Inflammatory Syndrome in Children (MIS-C) associated with COVID-19 has been described in the literature. MIS-C manifests mainly with fever and gastrointestinal symptoms and may mimic acute abdomen due to acute appendicitis. The objective of this study is to propose a care flowchart for suspected cases of acute appendicitis in the initial phase in pandemic times, considering the possibility of MIS-C. This situation was brought up by a patient treated in a pediatric hospital in Brazil. Discussion: It was possible to identify common signs and symptoms in the reported patient and those published cases that may serve as alerts for early identification of MIS-C cases. Based on the literature review and on the similarities between the syndrome and the inflammatory acute abdomen in children, we elaborated an initial approach for these cases to facilitate the identification, early diagnosis, and management. The flowchart considers details of the clinical history, physical examination, and complementary exams prior to the indication of appendectomy in patients with initial phase symptoms. Conclusion: MIS-C, although rare and of poorly known pathophysiology, is most often severe and has a high mortality risk. The use of the proposed flowchart can help in the diagnosis and early treatment of MIS-C.

NEW CORONAVIRUS INFECTION AS TRIGGER FACTOR FOR MULTISYSTEM INFLAMMATORY SYNDROME IN CHILDREN: LITERATURE REVIEW AND ANALYSIS OF ORIGINAL DATA

2020 ◽  
Vol 99 (6) ◽  
pp. 127-134
Author(s):  
S.R. Rodionovskaya ◽  
◽  
L.N. Mazankova ◽  
I.M. Osmanov ◽  
E.R. Samitova ◽  
...  
Keyword(s):  
Clinical Manifestations ◽  
Gastrointestinal Symptoms ◽  
Epidemiological Data ◽  
Original Data ◽  
Trigger Factor ◽  
Laboratory Markers ◽  
Systemic Glucocorticoids ◽  
Coronavirus Infection ◽  
Characteristic Features ◽  
Inflammatory Syndrome

The article presents data on the epidemiology, pathogenesis, features of clinical manifestations and diagnosis of multisystem inflammatory syndrome in children (MIS-C) associated with a new coronavirus infection. Objective of the research: to identify clinical manifestations and results of laboratory and instrumental examination of pediatric patients with confirmed MIS-C caused by a new coronavirus infection, the most characteristic features of this pathology and to analyze the amount of therapy based on the assessment of epidemiological data. Results: median age – 8 years (6; 9,5), median duration of the disease at the time of hospitalization – 6 days (3; 6). A positive result of SARS-CoV-2 analysis in rhinopharyngeal swabs by PCR was in 3 patients, antibodies to SARS-CoV-2 by ELISA were detected in 10. Clinical manifestations included prolonged febrile fever in 11 patients, gastrointestinal symptoms of varying severity – in 10, polymorphic rash was noted in 7 cases, conjunctivitis/scleritis – in 7, edema of the eyelids, face, extremities – in 4. CNS lesion manifested itself with general cerebral and meningeal symptoms. All patients had an increase in the level of inflammation laboratory markers. In 2 children chest MSCT revealed characteristic changes for SARS-CoV-2, interpreted as CT 3–4. Therapy included intravenous immunoglobulin infusions, systemic glucocorticoids, antiviral and antibacterial drugs, anticoagulants; two patients received tocilizumab infusions.

scholarly journals Specific Management of Patients with Acute Abdomen during the COVID-19 Pandemic: A Surgical Perspective from Germany

2020 ◽  
Vol 36 (5) ◽  
pp. 417-420
Author(s):  
Florian Kühn ◽  
Matthias Klein ◽  
Henning Laven ◽  
Nikolaus Börner ◽  
Tobias Weinberger ◽  
...  
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Epithelial Cells ◽  
Acute Abdomen ◽  
Clinical Features ◽  
Clinical Case ◽  
Acute Abdominal Pain ◽  
Gastrointestinal Symptoms ◽  
Critical Conditions ◽  
Specific Management

During the current COVID-19 pandemic, the triage, assessment, and management of patients presenting to the emergency department with critical conditions has become ­challenging. The clinical features of COVID-19 are heterogeneous and subtle in many cases. They may easily be overlooked in the case of other acute diseases. Gastrointestinal symptoms are common in patients with COVID-19 as SARS-CoV-2 is able to enter gastrointestinal epithelial cells. However, these complaints can also be caused by a COVID-19-independent concomitant abdominal pathology. Therefore, patients with acute abdominal pain and fever need to be assessed very thoroughly. Based on a clinical case, we present our approach of managing emergency patients with acute abdomen and concomitant suspicion of ­COVID-19.

scholarly journals COVID-19-associated gastrointestinal and liver injury: clinical features and potential mechanisms

2020 ◽  
Vol 5 (1) ◽  
Author(s):  
Peijie Zhong ◽  
Jing Xu ◽  
Dong Yang ◽  
Yue Shen ◽  
Lu Wang ◽  
...  
Keyword(s):  
Liver Injury ◽  
Ischemia Reperfusion Injury ◽  
Ischemia Reperfusion ◽  
Gastrointestinal Symptoms ◽  
Drug Induced ◽  
Viral Receptor ◽  
Oral Transmission ◽  
Systemic Inflammatory Reaction ◽  
Loss Of Appetite ◽  
Multiple Abnormalities

Abstract Coronavirus disease-2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The infection is spreading globally and poses a huge threat to human health. Besides common respiratory symptoms, some patients with COVID-19 experience gastrointestinal symptoms, such as diarrhea, nausea, vomiting, and loss of appetite. SARS-CoV-2 might infect the gastrointestinal tract through its viral receptor angiotensin-converting enzyme 2 (ACE2) and there is increasing evidence of a possible fecal–oral transmission route. In addition, there exist multiple abnormalities in liver enzymes. COVID-19-related liver injury may be due to drug-induced liver injury, systemic inflammatory reaction, and hypoxia–ischemia reperfusion injury. The direct toxic attack of SARS-CoV-2 on the liver is still questionable. This review highlights the manifestations and potential mechanisms of gastrointestinal and hepatic injuries in COVID-19 to raise awareness of digestive system injury in COVID-19.

scholarly journals Simil-appendicitis presentation may precede cardiac involvement in MIS-C patients

2021 ◽  
Author(s):  
Matteo Trevisan ◽  
Alessandro Amaddeo ◽  
Andrea Taddio ◽  
Alessandro Boscarelli ◽  
Egidio Barbi ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Children And Adolescents ◽  
Inflammatory Markers ◽  
Cardiac Involvement ◽  
Gastrointestinal Symptoms ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Cardiac Enzymes ◽  
Ventricular Ejection Fraction

Abstract BackgroundMultisystem inflammatory syndrome in children (MIS-C) is a new clinical entity characterized by a systemic hyperinflammation triggered by SARS-CoV-2 infection in children and adolescents. This condition could potentially involve all organs with main complications concerning cardiovascular system. Despite up to 90% of patients complain gastrointestinal symptoms (nausea, vomit and diarrhea), a presentation mimicking acute appendicitis has rarely been reported, and can be the presenting feature of the disease, potentially leading to misdiagnosis and delayed treatment.Case presentationA 15-year-old boy presented to the Emergency Department for a two-day history of fever, vomiting and mild abdominal pain. One month before, the patient complained ageusia and anosmia while his mother tested positive for Sars-CoV2 nasopharyngeal swab. At admission, laboratory tests showed leukocytosis with lymphopenia and elevation of inflammatory markers, while cardiac enzymes, electrocardiogram and echocardiography were unremarkable. An abdominal ultrasound displayed a thickening of terminal ileus and cecum with ascites. Because of the worsening abdominal pain and a physical examination suggestive of acute appendicitis, a laparoscopy was performed but no surgical condition was found. After surgery, fever and generalized malaise persisted, so a cardiac evaluation was repeated, showing a relevant increase in inflammatory markers and cardiac enzymes. Electrocardiogram demonstrated a QTc prolongation with mild decrease in left ventricular ejection fraction at echocardiogram. A MIS-C was diagnosed and intravenous immunoglobulin along with a steroid treatment started. After 36 hours, the patient presented a complete clinical recovery with fever cessation. Cardiac anomalies normalized in three weeks.ConclusionMIS-C has been defined as a systemic inflammation, involving at least two organs, after a previous SARS-CoV2 infection in children and adolescents. Physicians should be aware that while gastrointestinal manifestations are common, a pseudo appendicitis presentation may also occur, leading to misdiagnosis and delayed treatment. This report suggests that in patients with symptoms suggestive of an acute appendicitis, the presence of lymphopenia, hypoalbuminemia and ultrasound images of terminal ileus inflammation, should raise the suspect for MIS-C even without initial overt signs of cardiac involvement.

scholarly journals Clinical case of multisystem inflammatory syndrome development in a child with new coronavirus infection

2021 ◽  
Vol 20 (2) ◽  
pp. 60-63
Author(s):  
Yu. B. Belan ◽  
E. A. Gashina ◽  
E. F. Lobova ◽  
E. P. Shefer
Keyword(s):  
Infectious Diseases ◽  
Clinical Case ◽  
Maculopapular Rash ◽  
Present Patient ◽  
Clinical Hospital ◽  
Nasal Swabs ◽  
Coronavirus Infection ◽  
Inflammatory Syndrome

Objective: The article deals with a clinical case of new coronavirus infection in a 1 5-year-old child who was receiving treatment in an infectious diseases hospital of City Children's Clinical Hospital №3 during the period from 1 0 October to 1 December 2020.Materials and methods. The diagnosis was confirmed through nasal swabs examination for the presence of SARS-CoV-2 RNA using PCR and SARS-CoV-2 IgM detection through ELISA.Results. The main feature of the infection course in the present patient was multisystem inflammatory syndrome development with long-term fever, maculopapular rash and multisystemic lesions including bilateral pneumonia, acute carditis and polyserositis.

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