scholarly journals COVID-19 Multisystem Inflammatory Syndrome in Children (MIS-C) simulating as acute appendicitis: A case report

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Zorays Moazzam ◽  
Areej Salim ◽  
Kiran Hilal ◽  
Muhammad Arshad

Background: As the COVID-19 pandemic continues to disrupt global affairs through a variety of manifestations, a severe presentation of some COVID-19 pediatric patients has emerged, presenting as multisystem inflammatory syndrome in children (MIS-C) that may mimic surgical conditions. Case Presentation: We report the case of a 9-year-old boy who presented with acute, intermittent abdominal pain and fever. Further inquiry suggested a hyperinflammatory disorder affecting multiple organ systems. Upon COVID-19 PCR testing, the patient was reported as COVID-19 positive in the second test on the 2nd day of admission, after an initial negative test upon admission. We describe the course of this patient’s disease from presentation until discharge and discuss the emerging literature on this potentially fatal complication. Conclusion: MIS-C should be a differential diagnosis in patients who may present with acute abdominal pain in the emergency room.

2014 ◽  
Vol 25 (3) ◽  
pp. 266-278 ◽  
Author(s):  
Helen F. Brown ◽  
Lynn Kelso

Acute abdominal pain represents the cardinal symptom of a large number of intra-abdominal pathologies. Because of multiple organ systems, varied pathology from life threatening to benign, and differences in presentation related to sex and age, identifying a final diagnosis is a challenge. The clinician’s goal for patients with acute abdominal pain is to rapidly identify whether the underlying cause requires an urgent or immediate surgical intervention. By developing a systematic approach to evaluating patients with abdominal pain, clinicians can generate a differential diagnosis to ensure appropriate treatment and improved patient outcomes. The purpose of this article is to provide clinicians with a framework for evaluating the complaint of acute abdominal pain and recognizing patients who require expedited evaluation.


Author(s):  
Monica N. Naguib ◽  
Jennifer K. Raymond ◽  
Alaina P. Vidmar

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.


2021 ◽  
pp. 014556132110060
Author(s):  
Jérôme R. Lechien ◽  
Rémi Hervochon ◽  
Stéphane Hans

A 42-year-old man was referred for a week history of severe dysphagia, odynophagia, fever (39 °C), fatigue, abdominal pain, pharyngeal swelling, and multiple neck lymphadenopathies. The medical history reported a mild form of COVID-19 one month ago. The biology reported an unspecified inflammatory syndrome. The patient developed peritonitis, myocarditis, and hepatitis. A myocardium biopsy was performed. A diagnosis of Kawasaki-like disease (KLD) was performed. The occurrence of KLD in adults is rare but has to be known by otolaryngologists regarding the otolaryngological clinical presentation that may precede the multiple organ failure.


2021 ◽  
Vol 14 (4) ◽  
pp. e240533
Author(s):  
Rute Castelhano ◽  
Khine Myat Win ◽  
Sara Carty

Abdominal pain is a very common presentation in the accident and emergency department. However, vasculitis is not the usual first differential diagnosis. This paper discusses a case of polyarteritis nodosa presenting with acute abdominal pain alone. Common surgical conditions were obviously considered, but they were not found to cause the patient’s problems. We describe how investigations led to this diagnosis discussed in detail in this paper. It is important to remember that prompt recognition of unusual life-threatening conditions can lead to timely intervention.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Roham Borazjani ◽  
Seyed Reza Seraj ◽  
Mohammad Javad Fallahi ◽  
Zhila Rahmanian

Abstract Background COVID-19 pneumonia exhibits several extra-pulmonary complications. Case presentation A 23-year old, asthmatic male with coronavirus pneumonia developed with generalized, acute abdominal pain. Further evaluations revealed a mild ascites and portal vein thrombosis although the patient received proper anticoagulation therapy. Routine lab data regarding the secondary causes of portal vein thrombosis were normal. Conclusion We speculated that the underlying cause of portal vein thrombosis in our case was coronaviruses. Therefore, clinicians should always consider thrombosis and other hypercoagulable diseases in patients with COVID-19.


2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Edgar Stroppa Lamas ◽  
Alan Vinicius Gamero Osti

Background. Splenic infarction is a rare clinical condition. It is generally attributed to hematologic, vascular, cardioembolic, and infectious diseases or trauma. Case Presentation. We describe a rare case in an otherwise asymptomatic 41-year-old overweight woman with acute abdominal pain. Imaging work-up revealed splenic infarction. Common etiologies were excluded. A transesophageal echocardiography (TEE) revealed a patent foramen ovale (PFO). The patient was sent to closure with good outcome. Conclusion. Paradoxical embolism due to PFO can be a cause of splenic infarction, and its investigation and subsequent closure may be considered when there are no other causative disorders.


2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Javier Martín-Vallejo ◽  
Enrique E. Garrigós-Llabata ◽  
Patricia Molina-Bellido ◽  
Pedro A. Clemente-Pérez

Abstract Background Isolated fallopian tube torsion associated with hydrosalpinx is a rare condition in the pediatric population. We present this unusual clinical case study in a sexually inactive girl. Case presentation a12-year-old Caucasian girl presented symptoms of acute abdominal pain. Pelvic ultrasound revealed a normal looking uterus and ovaries and next to left ovary a imaging compatible with hydrosalpinx. She was discharged 48 hours later after clinical monitoring with oral analgesia and normal blood workup. At 3 weeks, she was readmitted for acute abdominal pain. Leukocytosis with left shift and raised C-reactive protein were observed. Her clinical condition worsened, and complication of the preexisting hydrosalpinx was suspected. Exploratory laparoscopy confirmed torsion of the fallopian tube. Left salpingectomy was performed. Histopathologic study confirmed a fallopian tube with hemorrhagic infarct. Conclusion Torsion of the fallopian tube must be considered in the event of acute abdominal pain. Early diagnosis and trying conservative management with a view to preserving fertility in this group of patients are essential.


2021 ◽  
Vol 7 (2) ◽  
pp. 98-102
Author(s):  
R H Gobbur ◽  
Ranjima M ◽  
Aravind S Akki

During the current COVID-19 pandemic, the assessment, and management of patients are challenging. The clinical features of COVID-19 are heterogeneous and subtle in many cases. Although diffuse alveolar damage and acute respiratory failure are the main features of COVID-19, the impairment of other organs are also seen. Gastrointestinal symptoms are common in pediatric 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 fever with acute abdominal pain, anorexia, nausea, vomiting and diarrhea need to be assessed very thoroughly. Previous studies reported that COVID-19 was likely to result in liver injury. Based on clinical cases, we present our approach of management of children with symptoms and signs of viral hepatitis and concomitant suspicion of ­COVID-19.


Author(s):  
Hala Atta Youssef ◽  
Aishah Mohammad Alkhaldi ◽  
Manar Mohammed Alshahrani ◽  
Abdullah Tariq Almalki ◽  
Amjad Ali Alahmari ◽  
...  

Reports showed that children usually complained of acute abdominal pain, which indicated the presence of severe underlying conditions and can have significant clinical importance. Serious challenges have been reported in healthcare settings where an urgent evaluation of the cases was necessary to adequately manage the patient before developing serious complications that might even end up with death. Some of these conditions included intussusception, appendicitis, volvulus and adhesions. Although estimates indicated that only around 1% of pediatric patients with acute abdominal pain usually required surgical intervention, concerns regarding the overlooking and misdiagnosis of significant conditions that might have severe prognostic outcomes were aroused among the different emergency departments. This study reviewed the common causes of acute abdominal pain among children admitted to the emergency department. Our results indicated that various etiologies can develop acute abdominal pain and therefore, establishing an adequate diagnosis by differentiating between the different etiologies should be done by the attending physicians to enhance the outcomes and adequately manage the admitted patients. Gastrointestinal causes of acute abdominal pain were the commonest to cause admissions to the emergency department. However, care should also be provided to the less common conditions, which might include genitourinary and pulmonary disorders and therefore, a thorough examination of children should be provided not to conduct a misdiagnosis of the underlying condition.


PRILOZI ◽  
2021 ◽  
Vol 42 (2) ◽  
pp. 95-101
Author(s):  
Lidija Kareva ◽  
Katarina Stavrik ◽  
Kristina Mironska ◽  
Arjeta Hasani ◽  
Sonja Bojadzieva ◽  
...  

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.


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