A RARE CASE OF MULTISYSTEM INFLAMMATORY SYNDROME IN CHILDREN (MIS-C) TEMPORALLY RELATED TO COVID-19 IN A 2-MONTH-OLD INFANT WITH CARDIOVASCULAR AND NEUROLOGICAL INVOLVEMENT

2021 ◽  
pp. 69-71
Author(s):  
Deepa A Banker ◽  
Ishani Sarda ◽  
Bhavdeep M Munga ◽  
Vimal T Maheshwari

Multisystem Inammatory syndrome in Children (MIS-C) temporally associated to Coronavirus disease 2019 (COVID-19) is a life-threatening condition. It has been commonly reported in the school going age group. We present a rare case of a two-month-old infant who was real time polymerase chain reaction (RT-PCR) positive for the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) fullling the World Health Organisation (WHO) criteria for MISC. Cardiac and inammatory markers were raised at the time of admission with echocardiography showing biventricular dysfunction. Patient was treated with a course of intravenous immunoglobulin (IVIg) with rapid clinical improvement. During the course of hospital stay, patient developed generalised tonic-clonic seizures with magnetic resonance imaging (MRI) of the brain th suggestive of viral encephalitis. Patient was vitally stable and symptom free by the 10 day of admission and subsequ

2021 ◽  
Vol 14 (9) ◽  
pp. e244769
Author(s):  
Chee Chean Lim ◽  
Jeyasakthy Saniasiaya ◽  
Jeyanthi Kulasegarah

Croup (laryngotracheitis) is frequently encountered in the emergency department in a young child presenting with stridor. We describe a rare case of croup secondary to SARS-CoV-2 in an 18-month-old child who presented with stridor and respiratory distress and required urgent intubation. Subsequently, the child developed multisystem inflammatory syndrome in children (MIS-C). The child was monitored in paediatric intensive care unit. We would like to highlight that COVID-19 croup in children may be an indicator for MIS-C, and close monitoring is warranted as MIS-C is a life-threatening condition. Our limited experience suggests that COVID-19 croup especially if associated with MIS-C has an underlying more severe pathology and may require prolonged treatment in comparison with the typical croup or even COVID-19 croup. It is important to recognise this clinical entity during a time when most countries are in a third wave of COVID-19 pandemic.


2020 ◽  
Vol 49 (9) ◽  
pp. 661-668
Author(s):  
Alvin HY Lo ◽  
Adrian CL Kee ◽  
Andrew Li ◽  
Francesca Rubulotta

Sepsis is life-threatening and might potentially progress from dysregulation to severe organ dysfunction. It is recognised by the World Health Organisation as a global health priority. The mortality rate for sepsis has decreased in many countries, and this is credited to the earlier recognition and treatment of this complex syndrome. In 2002, the Surviving Sepsis Campaign was launched, and there have been several revisions to the sepsis recommendations therefrom. The latest sepsis guidelines focus on viral as well as bacterial infections, and advise that initiating resuscitation and management should take place within one hour from when sepsis is initially suspected. Numerous studies and guidelines pertaining to sepsis management have been published over the past 2 decades. The use of novel therapies and alternative adjunctive therapies has tremendous potential in sepsis management. Debates amongst intensivists exist with the creation of updated sepsis guidelines and advances in treatment. The present review article provides both a summary and recommendations based on the latest clinical evidence and controversies around sepsis management. Key words: Critical Care Medicine, Intensive Care Medicine, Respiratory Medicine, Sepsis, Sepsis Bundles, Sepsis Management


2021 ◽  
Vol 7 (4) ◽  
pp. 218-220
Author(s):  
Raghavendra H Gobbur ◽  
Ranjima M Mahesh

As COVID-19 continues to spread in India and other countries, the impact of the disease among children, initially considered less important, is becoming more relevant. The extent of the diversity of clinical presentation of COVID-19 in children are still unclear. We have already seen a new clinical picture of SARS-CoV-2 in children manifesting as a hyper-inflammatory syndrome, with multi-organ involvement similar to Kawasaki Disease and with potential evolution to a shock syndrome. This represented a new phenomenon affecting previously asymptomatic children with SARS-CoV-2 infection. COVID-19 may also manifest as viral hepatitis, acute pancreatitis, acute liver injury, acute kidney injury, ARDS, Sepsis, septic shock and meningo-encephalitis and cerebellar ataxia. The Multisystem Inflammatory Syndrome in Children (MIS-C) associated with SARS-CoV-2 infection occurs weeks after infection and may evolve unnoticed. MIS-Cs pathophysiology remains unclear. However, it appears to be a postinfectious hyperimmune response that may occur during or following asymptomatic or symptomatic infection. COVID-19 infection in children may lead to a potentially life threatening condition that we may not be aware of. We are in need of reporting of the diverse presentation of SARS CoV-2 virus in children. Here we describe a case of a previously normal 14-year-old boy who manifested with severe pain abdomen after SARS CoV-2 infection and was diagnosed as Acute Ileocolitis secondary to COVID-19. Child improved with steroid therapy and was asymptomatic after 3 weeks of treatment.


2018 ◽  
Vol 31 (2) ◽  
pp. 65-68
Author(s):  
Justyna Pasternak ◽  
Ewa Kliszczewska ◽  
Malgorzata Polz-Dacewicz

Abstract Polyomavirus (PyV) was discovered by accident in 1950 in the course of describing an infectious factor causing multiple tumours in rodents. The term is derived from two Greek words: poly (many) and oma (tumour). At present the family of human polyomaviruses (HPyV) consists of 10 members. One of the first members was BK virus, isolated in 1971 from the urine of a renal transplant patient. Serological examinations have shown that due to its ability to cause latent infection, about 90% of the general population can have specific antibodies attesting infection. In the case of infected persons with normal immunity, this virus is not dangerous. In the impaired immunity, however, loss of immunity results in virus reactivation and development of many life-threatening illnesses. Serological examinations have also reveal that BK polyomavirus considerably affects the development of cancers in humans. Hence, in 2012 a group of 26 researchers from 11 countries associated with the International Agency for Research on Cancer (a part of the World Health Organisation) classified BK polyomavirus within group 2B - “potentially carcinogenic to humans”


2015 ◽  
Vol 2 (4) ◽  
pp. G25-G27 ◽  
Author(s):  
Vishal Sharma ◽  
Susan Alderton ◽  
Helen McNamara ◽  
Richard Steeds ◽  
Will Bradlow ◽  
...  

The World Health Organisation (WHO) launched the Surgical Safety Checklist in 2008. The introduction of this checklist resulted in a significant reduction in the incidence of complications and death in patients undergoing surgery. Consequently, the WHO Surgical Safety checklist is recommended for use by the National Patient Safety Agency for all patients undergoing surgery. However, many invasive or interventional procedures occur outside the theatre setting and there are increasing requirements for a safety checklist to be used prior to such procedures. Transoesophageal echocardiography (TOE) is an invasive procedure and although generally considered to be safe, it carries the risk of serious and potentially life-threatening complications. Strict adherence to a safety checklist may reduce the rate of significant complications during TOE. However, the standard WHO Surgical Safety Checklist is not designed for procedures outside the theatre environment and therefore this document is designed to be a procedure-specific safety checklist for TOE. It has been endorsed for use by the British Society of Echocardiography and the Association of Cardiothoracic Anaesthetists.


2021 ◽  
pp. 78-78
Author(s):  
Milena Bjelica ◽  
Gordana Vilotijevic-Dautovic ◽  
Andrea Djuretic ◽  
Slobodan Spasojevic

Introduction. Multisystem inflammatory syndrome in children (MIS-C) is a post-viral, life-threatening, inflammatory state with multisystem involvement that typically manifests 3-4 weeks after SARS-CoV-2 infection. In this article, we present the first case of MIS-C in the Institute for Child and Youth Health Care of Vojvodina at the beginning of the COVID-19 pandemic. Case outline. A previously 11-years-old healthy girl got sick two days before admission to the hospital with a fever, headache, vomiting, abdominal pain, and fatigue. She was tested positive for COVID-19 by nasopharyngeal swab PCR with positive IgM and IgG antibodies. In the further course the illness presented with prolonged fever, laboratory evidence of inflammation, multiorgan involvement such as respiratory, gastrointestinal, cardiovascular, and dermatologic. Based on Centers for Disease Control and Prevention and World Health Organization criteria the diagnosis of MIS-C was made and IVIG and methylprednisolone were introduced with favorable clinical course. Conclusion. Every prolonged and unusual febrile state, especially if it is accompanied by gastrointestinal symptoms, in a school-age child, should be investigated in the direction of recent COVID-19 infection or exposure. In a case of a positive COVID-19 history or history of exposure, the MIS-C diagnosis should be considered.


2021 ◽  
pp. 1-2
Author(s):  
Shridhar Dave ◽  
Vishalkumar Bhardava ◽  
Bhavya Shah

Chronic ectopic pregnancy is a life threatening condition which is challenging to diagnose, occurs when trophoblastic tissue invades implanted structure causing a protracted destruction at site of attachment, leads to repeated minor bleeding. And with time a haematocele is formed, leading to inflammatory reaction and chronic pelvic adhesions which resemble complex pelvic mass1. Here 25 year old female presented with amenorrhea for 5 weeks with pain in abdomen and was diagnosed to have chronic ectopic pregnancy on MRI.


2021 ◽  
pp. 66-67
Author(s):  
Meghna Barmase

Fetal midgut volvulus is an extremely rare life threatening condition with poor prognosis. It often remains undiagnosed on antenatal ultrasound and manifest as intestinal obstruction in both antenatal and post natal period. Following is the case report of intrauterine midgut volvulus causing proximal obstruction of stomach and duodenum. The infant survived postnatally after caesarean section delivery with prompt and appropriate surgical intervention. Twisting of bowel loops around the mesenteric vessels suggestive of whirpool sign was the most signicant clue leading to the diagnosis of volvulus.


2008 ◽  
Vol 9 (4) ◽  
pp. 387-389 ◽  
Author(s):  
Michael Papadakis ◽  
George Sapkas ◽  
Apostolos Tzoutzopoulos

Spinal surgery–associated rhabdomyolysis, although rare, is a life-threatening condition. Presented here is the case of a middle-aged, overweight man who underwent posterior lumbar surgery because of pain and neurogenic claudication. His postoperative course was complicated by the occurrence of rhabdomyolysis. Despite adequate treatment, acute renal failure developed as a sequela. His condition was grave enough to require the administration of intermittent hemodialysis. After a prolonged hospitalization and 5 sessions of hemodialysis, the patient achieved a full recovery. In view of the fact that rhabdomyolysis-induced acute renal failure is associated with a mortality rate of 20–50%, the outcome was favorable.


2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Ashar Dhana

Despite access to antiretroviral therapy, mortality from cryptococcal meningitis (CM) is high among persons with advanced HIV infection in sub-Saharan Africa. Cryptococcal antigen (CrAg) is present several weeks to months before the onset of symptoms of meningitis and can be screened to prevent life threatening meningitis. Recently, the World Health Organisation recommended that a new rapid CrAg lateral flow ‘‘dipstick’’ assay (LFA) is to be used to screen HIV-infected persons with CD4 counts of less than 100 cells/µL. In this paper, we describe two cases of cryptococcosis with differing outcomes. In the first case, the new CrAg LFA was used as part of a screen and preemptive treatment strategy to prevent CM. In the second case, our patient had no access to the CrAg LFA and subsequently developed life threatening meningitis. To the best of our knowledge, this is the first case report of cryptococcosis diagnosed using this novel assay.


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