A PARTICULAR CASE OF SARS-COV-2 INFECTION IN TWINS

Introduction. Although SARS-CoV-2 infection is more common in adults, many cases have been reported in the pediatric population. Case presentation. An 8-month-old infant from twin pregnancy, confirmed with COVID-19, is hospitalized with nasal obstruction, serous rhinorrhea, rare cough and watery stools. The epidemiological link is known, both the parents and the maternal grandparents of the infant being confirmed with COVID-19. Biologically, he presented with thrombocytosis and discrete inflammatory syndrome, and the lung radiograph did not show any lesions. At the same time, the twin sister was hospitalized, who presented a similar symptomatology, with a negative SARS-CoV-2 PCR test, but the lung radiograph showed specific lesions of COVID-19. During hospitalization, 2 more SARS-CoV-2 PCR tests were performed, but with negative results. The evolution of the twins was favorable under symptomatic treatment, respectively antibiotic and symptomatic treatment. Conclusion. SARS-CoV-2 infection may be asymptomatic, especially in infants and newborns, and has a lower prevalence.

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Pediatric P-ANCA Vasculitis following COVID-19

10.22541/au.162055806.69831997/v1 ◽

2021 ◽

Author(s):

Yaron Fireizen ◽

Cyrus Shahriary ◽

Maria Imperial ◽

Inderpal Randhawa ◽

Nastasia Nianiaris ◽

...

Keyword(s):

Pediatric Population ◽

Kidney Injury ◽

The Body ◽

Pediatric Case ◽

Case Presentation ◽

Necrotizing Glomerulonephritis ◽

History Of ◽

Complex Deposition ◽

Inflammatory Syndrome ◽

Pulse Steroids

Background: Perinuclear anti-neutrophil cytoplasmic antibodies (P-ANCA), a subset of ANCA, are associated with a multisystem vasculitis affecting small blood vessels in the body. A handful of adult patients who developed vasculitis post-COVID-19 infection have been reported. Although COVID-19 infection has been shown to drive an exaggerated immune response in the pediatric population, such as MIS-C (multisystem inflammatory syndrome in children), only one case of vasculitis following COVID-19 infection has been reported previously in children. Case presentation: Seventeen-year-old male with a past medical history of COVID-19 pneumonia two months prior presented with acute kidney injury/failure and diffuse alveolar hemorrhage (DAH). Rheumatologic workup revealed P-ANCA and Myeloperoxidase (MPO) positivity. Kidney biopsy showed necrotizing glomerulonephritis with limited immune complex deposition. Subsequently, he was treated with pulse steroids, plasmapheresis, and ultimately started on cyclophosphamide. Conclusions: To our knowledge, this report presents the second reported pediatric case of P-ANCA / MPO vasculitis following COVID-19 infection.

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Refractory pharyngeal ulceration due to cytomegalovirus in a patient with HIV infection: a case report and literature review

BMC Infectious Diseases ◽

10.1186/s12879-021-05943-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Morichika Osa ◽

Akihiro Sato ◽

Maki Sakagami ◽

Masaki Machida ◽

Takao Sato ◽

...

Keyword(s):

Hiv Infection ◽

Pathological Examination ◽

Cmv Infection ◽

Case Presentation ◽

Immunodeficiency Virus ◽

Before And After ◽

Infected Cells ◽

Immunocompromised Hosts ◽

Inflammatory Syndrome ◽

Nonspecific Inflammation

Abstract Background Cytomegalovirus (CMV) is an important pathogen among immunocompromised hosts. Typically, CMV in human immunodeficiency virus (HIV) infection causes diseases of the retina, digestive tract, lungs and liver, but there are few cases of CMV infection of the pharynx and larynx. Case presentation A 57-year-old man with HIV infection was admitted because of pharyngeal pain. Before and after admission, pharyngeal biopsies guided by laryngeal endoscopy were performed four times, but pathological examination showed nonspecific inflammation, and the cause of pharyngeal ulceration was unclear. Additionally, the ulceration deteriorated after initiation of retroviral therapy. Laryngomicrosurgery was conducted under general anesthesia to remove tissue, and pathological diagnosis confirmed CMV infection. Pathological features included enlargement of the cytoplasm and nucleus in infected cells, and intranuclear bodies called owl’s eye inclusions. Ganciclovir dramatically improved the symptoms and laryngoscopic findings. Conclusions This case was diagnosed as pharyngitis and pharyngeal ulceration caused by CMV infection, related to immune reconstitution inflammatory syndrome. In previous reports of CMV-induced pharyngeal or laryngeal ulceration in HIV infection, we found six cases similar to our present case. All cases were diagnosed by biopsy. The present case indicates the importance of biopsy for definitive diagnosis. CMV infection should be considered as a differential diagnosis of pharyngeal ulceration in patients with HIV infection.

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New onset diabetes with diabetic ketoacidosis in a child with multisystem inflammatory syndrome due to COVID-19

Journal of Pediatric Endocrinology and Metabolism ◽

10.1515/jpem-2020-0426 ◽

2020 ◽

Vol 0 (0) ◽

Cited By ~ 1

Author(s):

Monica N. Naguib ◽

Jennifer K. Raymond ◽

Alaina P. Vidmar

Keyword(s):

Metabolic Acidosis ◽

Diabetic Ketoacidosis ◽

Pediatric Patients ◽

Systolic Function ◽

Hemodynamic Instability ◽

Case Presentation ◽

Onset Diabetes ◽

Potential Trigger ◽

Inflammatory Syndrome ◽

New Onset

AbstractIntroductionMultisystem inflammatory syndrome in children (MIS-C) is a unique clinical complication of SARS-CoV-2 infection observed in pediatric patients. COVID-19 is emerging as a potential trigger for the development of diabetes in children. Here, we report a patient presenting with MIS-C and new onset diabetes, and discuss the implication and clinical management of these concomitant conditions.Case presentationAn eight-year-old female presented with hyperglycemia, ketosis and metabolic acidosis consistent with diabetic ketoacidosis (DKA) in the setting of fever, rash, respiratory distress, hemodynamic instability, reduced systolic function with dilation of the left anterior descending artery, and positive SARS-CoV-2 antibodies suggestive of MIS-C.

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Superiority of MALDI-TOF Mass Spectrometry over Real-Time PCR for SARS-CoV-2 RNA Detection

Viruses ◽

10.3390/v13050730 ◽

2021 ◽

Vol 13 (5) ◽

pp. 730

Author(s):

Magda Rybicka ◽

Ewa Miłosz ◽

Krzysztof Piotr Bielawski

Keyword(s):

Mass Spectrometry ◽

Gold Standard ◽

Viral Genome ◽

False Negative ◽

Rt Pcr ◽

Rna Detection ◽

Maldi Tof ◽

Negative Results ◽

False Negative Results ◽

Pcr Test

At present, the RT-PCR test remains the gold standard for early diagnosis of SARS-CoV-2. Nevertheless, there is growing evidence demonstrating that this technique may generate false-negative results. Here, we aimed to compare the new mass spectrometry-based assay MassARRAY® SARS-CoV-2 Panel with the RT-PCR diagnostic test approved for clinical use. The study group consisted of 168 suspected patients with symptoms of a respiratory infection. After simultaneous analysis by RT-PCR and mass spectrometry methods, we obtained discordant results for 17 samples (10.12%). Within fifteen samples officially reported as presumptive positive, 13 were positive according to the MS-based assay. Moreover, four samples reported by the officially approved RT-PCR as negative were positive in at least one MS assay. We have successfully demonstrated superior sensitivity of the MS-based assay in SARS-CoV-2 detection, showing that MALDI-TOF MS seems to be ideal for the detection as well as discrimination of mutations within the viral genome.

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A Systematic Review of Characteristics Associated with COVID-19 in Children with Typical Presentation and with Multisystem Inflammatory Syndrome

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18168269 ◽

2021 ◽

Vol 18 (16) ◽

pp. 8269

Author(s):

Jeffrey Kornitzer ◽

Jacklyn Johnson ◽

Max Yang ◽

Keith W. Pecor ◽

Nicholas Cohen ◽

...

Keyword(s):

Systematic Review ◽

Sore Throat ◽

Literature Search ◽

Clinical Presentation ◽

Pediatric Population ◽

Chinese Language ◽

Clinical Information ◽

Shortness Of Breath ◽

Global Pandemic ◽

Inflammatory Syndrome

Setting off a global pandemic, coronavirus disease 2019 (COVID-19) has been marked by a heterogeneous clinical presentation that runs the gamut from asymptomatic to severe and fatal. Although less lethal in children than adults, COVID-19 has nonetheless afflicted the pediatric population. This systematic review used clinical information from published literature to assess the spectrum of COVID-19 presentation in children, with special emphasis on characteristics associated with multisystem inflammatory syndrome (MIS-C). An electronic literature search for English and Chinese language articles in COVIDSeer, MEDLINE, and PubMed from 1 January 2020 through 1 March 2021 returned 579 records, of which 54 were included for full evaluation. Out of the total 4811 patients, 543 (11.29%) exhibited MIS-C. The most common symptoms across all children were fever and sore throat. Children presenting with MIS-C were less likely to exhibit sore throat and respiratory symptoms (i.e., cough, shortness of breath) compared to children without MIS-C. Inflammatory (e.g., rash, fever, and weakness) and gastrointestinal (e.g., nausea/vomiting and diarrhea) symptoms were present to a greater extent in children with both COVID-19 and MIS-C, suggesting that children testing positive for COVID-19 and exhibiting such symptoms should be evaluated for MIS-C.

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Recurrent schwannoma of the tongue in a pediatric patient—report of a rare case with an updated review of literature

The Egyptian Journal of Otolaryngology ◽

10.1186/s43163-021-00101-0 ◽

2021 ◽

Vol 37 (1) ◽

Author(s):

Anup Singh ◽

Vaisakh Kuzhikkali ◽

Arvind Kumar Kairo

Keyword(s):

Pediatric Population ◽

Surgical Excision ◽

Review Of Literature ◽

Case Presentation ◽

Nerve Sheath Tumors ◽

Peripheral Nerve Sheath Tumors ◽

Nerve Sheath ◽

Cervical Sympathetic ◽

Mobile Tongue

Abstract Background Head and neck is a relatively common site of occurrence for the peripheral nerve sheath tumors, and majority of these tumors are seen involving neck, involving vagus nerve, and cervical sympathetic chain. Schwannomas involving mobile tongue are rarely encountered, especially in the pediatric population Case presentation We present a case of recurrent tongue schwannoma in a 13-year-old female successfully managed with transoral excision. At a follow-up of 3 years, no recurrence is observed. Conclusion Surgical excision is the recommended modality of treatment for lingual schwannomas, and when excised adequately, recurrences are not expected. A clear margin of surrounding normal tissue should be aimed for to avoid possible recurrence.

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Adult post COVID-19 multisystem inflammatory syndrome and thrombotic microangiopathy

10.21203/rs.3.rs-76310/v1 ◽

2020 ◽

Cited By ~ 1

Author(s):

Idris Boudhabhay ◽

Marion Rabant ◽

Louis-Marie Coupry ◽

Armance Marchal ◽

Lubka T Roumenina ◽

...

Keyword(s):

Renal Function ◽

Thrombotic Microangiopathy ◽

Dramatic Improvement ◽

Case Presentation ◽

Complement Inhibition ◽

Clinical Series ◽

Long Term Consequences ◽

Inflammatory Syndrome

Abstract Background: The coronavirus disease 2019 pandemic has affected millions of people worldwide but medium and long-term consequences are unknown. Clinical series of Kawasaki-like multisystem inflammatory syndrome in children (MIS-C), occurring after SARS-Cov-2 spreading, have been recently described. Case presentation: We describe a case of post COVID-19 MIS in a 46-year-old man, with biopsy-proven renal thrombotic microangiopathy (TMA). Specific complement inhibition with Eculizumab was initiated promptly and lead to a dramatic improvement of renal function. Conclusion: Our case suggests that post COVID-19 MIS is not restricted to children and that TMA could play a central role in the pathophysiology of this syndrome

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Paediatric inflammatory multisystem syndrome temporally associated with COVID-19: a new virus and a new case presentation

BMJ Case Reports ◽

10.1136/bcr-2020-238531 ◽

2020 ◽

Vol 13 (12) ◽

pp. e238531

Author(s):

Phoebe Makiello ◽

Sima Svirpliene ◽

Lisa Finlay ◽

Jean McKnight

Keyword(s):

Clinical Symptoms ◽

Late Phase ◽

Upper Airway ◽

Intravenous Immunoglobulins ◽

Left Ventricular ◽

Haemodynamic Instability ◽

Case Presentation ◽

Full Resolution ◽

Inflammatory Syndrome

An 11-year-old boy presented with features resembling those described in health alerts on Paediatric Inflammatory Multisystem Syndrome Temporally associated with SARS-CoV-2 (PIMS-TS), including persistent fever, haemodynamic instability and abdominal pain. Laboratory tests, including raised inflammatory markers, D-dimer, troponin and a coagulopathy, were consistent with PIMS-TS. Our patient required transfer to the paediatric intensive care unit; an echocardiography revealed left ventricular dysfunction. He was treated with intravenous immunoglobulins (Igs), corticosteroids and aspirin, with full resolution of clinical symptoms. A follow-up echocardiogram 1 month after discharge was unremarkable.Three SARS-CoV-2 PCRs on respiratory samples, taken over the initial 4-day period, were negative, as was a SARS-CoV-2 PCR on faeces 1 month after presentation; titres of IgG were clearly elevated. The negative PCRs in the presence of elevated titres of IgG suggest that the inflammatory syndrome might have developed in a late phase of COVID-19 infection when the virus was no longer detectable in the upper airway.

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Accuracy of the QuantiFERON-TB Gold in Tube for diagnosing tuberculosis in a young pediatric population previously vaccinated with Bacille Calmette-Guerin

Revista Paulista de Pediatria ◽

10.1590/s0103-05822014000100002 ◽

2014 ◽

Vol 32 (1) ◽

pp. 04-10 ◽

Cited By ~ 2

Author(s):

Marcelo Genofre Vallada ◽

Thelma Suely Okay ◽

Gilda Maria B. Del Negro ◽

Claudio Amaral Antonio ◽

Lidia Yamamoto ◽

...

Keyword(s):

Mycobacterium Tuberculosis ◽

Roc Curve ◽

Pediatric Population ◽

Area Under The Curve ◽

Mycobacterial Infection ◽

Tuberculosis Infection ◽

Mycobacterium Tuberculosis Infection ◽

Assay Sensitivity ◽

Negative Results ◽

Release Assay

Objective: To evaluate the accuracy of an interferongamma release assay (QuantiFERON-TB Gold in Tube) for diagnosing Mycobacterium tuberculosis infection in a young pediatric population. Methods: 195 children previously vaccinated with BCG were evaluated, being 184 healthy individuals with no clinical or epidemiological evidence of mycobacterial infection, and 11 with Mycobacterium tuberculosis infection, according to clinical, radiological, and laboratory parameters. A blood sample was obtained from each child and processed according to the manufacturer's instructions. The assay performance was evaluated by a Receiver Operating Characteristic (ROC) curve. Results: In the group of 184 non-infected children, 130 (70.6%) were under the age of four years (mean age of 35 months). In this group, 177 children (96.2%) had negative test results, six (3.2%) had indeterminate results, and one (0.5%) had a positive result. In the group of 11 infected children, the mean age was 58.5 months, and two of them (18%) had negative results. The ROC curve had an area under the curve of 0.88 (95%CI 0.82-0.92; p<0.001), disclosing a predictive positive value of 81.8% for the test (95%CI 46.3-97.4). The assay sensitivity was 81.8% (95%CI 48.2-97.2) and the specificity was 98.8% (95%CI 96-99.8). Conclusions: In the present study, the QuantiFERON-TB Gold in Tube performance for diagnosing M. tuberculosis infection was appropriate in a young pediatric population.

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A young adult with COVID-19 and multisystem inflammatory syndrome in children (MIS-C)-like illness: a case report

BMC Infectious Diseases ◽

10.1186/s12879-020-05439-z ◽

2020 ◽

Vol 20 (1) ◽

Cited By ~ 1

Author(s):

Aaron D. Kofman ◽

Emma K. Sizemore ◽

Joshua F. Detelich ◽

Benjamin Albrecht ◽

Anne L. Piantadosi

Keyword(s):

Cardiac Dysfunction ◽

Clinical Characteristics ◽

Kidney Injury ◽

Clinical Findings ◽

Low Grade ◽

Rare Form ◽

Case Presentation ◽

Lymph Node Swelling ◽

Inflammatory Syndrome

Abstract Background A healthy 25-year-old woman developed COVID-19 disease with clinical characteristics resembling Multisystem Inflammatory Syndrome in Children (MIS-C), a rare form of COVID-19 described primarily in children under 21 years of age. Case presentation The patient presented with 1 week of weakness, dyspnea, and low-grade fevers, followed by mild cough, sore throat, vomiting, diarrhea, and lymph node swelling. She was otherwise healthy, with no prior medical history. Her hospital course was notable for profound acute kidney injury, leukocytosis, hypotension, and cardiac dysfunction requiring ICU admission and vasopressor support. MIS-C-like illness secondary to COVID-19 was suspected due to physical exam findings of conjunctivitis, mucositis, and shock. She improved following IVIG, aspirin, and supportive care, and was discharged on hospital day 5. Conclusion MIS-C-like illness should be considered in adults presenting with atypical clinical findings and concern for COVID-19. Further research is needed to support the role of IVIG and aspirin in this patient population.

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